Boccatonda A, Stupia R, Serra C. Ultrasound, contrast-enhanced ultrasound and pyelonephritis: A narrative review. World J Nephrol 2024; 13(3): 98300 [PMID: 39351183 DOI: 10.5527/wjn.v13.i3.98300]
Corresponding Author of This Article
Andrea Boccatonda, MD, Research Fellow, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Zamboni N 33, Bologna 40126, Italy. andrea.boccatonda2@unibo.it
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Opinion Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Sep 25, 2024; 13(3): 98300 Published online Sep 25, 2024. doi: 10.5527/wjn.v13.i3.98300
Ultrasound, contrast-enhanced ultrasound and pyelonephritis: A narrative review
Andrea Boccatonda, Roberta Stupia, Carla Serra
Andrea Boccatonda, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna 40126, Italy
Roberta Stupia, Department of General Medicine C, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Verona 37134, Italy
Carla Serra, Department of Medical Liver Transplant Care, General and University Hospital S. Orsola-Malpighi, Bologna 40138, Italy
Co-first authors: Andrea Boccatonda and Roberta Stupia.
Author contributions: Boccatonda A was responsible for the conceptualization; Stupia R was responsible for the writing and editing; Serra C was responsible for expert review; All authors have read and approved the final manuscript. Boccatonda A and Stupia R collaborated equally in the study conception, data collection and manuscript writing efforts that were crucial to this study’s successful completion, meriting the co-first authorship designation.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrea Boccatonda, MD, Research Fellow, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Zamboni N 33, Bologna 40126, Italy. andrea.boccatonda2@unibo.it
Received: June 24, 2024 Revised: July 26, 2024 Accepted: August 5, 2024 Published online: September 25, 2024 Processing time: 87 Days and 3.2 Hours
Abstract
Acute pyelonephritis (APN) is a bacterial infection resulting in kidney inflammation, typically arising as a complication of an ascending urinary tract infection that ascends from the bladder to the kidneys. Clinical diagnosis is generally based on clinical and laboratory findings. Recent guidelines recommend not performing diagnostic imaging unless a complicated APN is suspected or the infection affects high-risk patients such as the elderly, immunocompromised individuals, or diabetics. Contrast-enhanced ultrasound (CEUS) is a valuable tool in both the diagnosis and follow-up of APN. It aids in distinguishing small simple nephritic involvement from abscess complications and monitoring their evolution over time during antibiotic therapy. Given its lack of ionizing radiation and nephrotoxicity, CEUS is a valid diagnostic modality for approaching and monitoring pyelonephritis, improving early identification and characterization of inflammatory lesions. This review aims to summarize the main evidence on the use of ultrasound and CEUS in the diagnosis of APN and its follow-up.
Core Tip: Acute pyelonephritis (APN) is a kidney inflammation typically due to an ascending urinary tract bacterial infection. The diagnosis is suggested by clinical and laboratory findings. Diagnostic imaging should be performed in case of a complicated APN. Contrast-enhanced ultrasound (CEUS) is a valid diagnostic tool for evaluating APN and performing a follow-up. This review aims to summarize the main evidence on the use of ultrasound and CEUS in the diagnosis of APN and its follow-up.
