Which CT scan findings indicate complications of acute pyelonephritis?

Updated: Jul 01, 2021
  • Author: Tibor Fulop, MD, PhD, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
  • Print
Answer

Abscesses typically appear on CT scans as low-density masses with contrast enhancement of the wall from inflamed/dilated blood vessels (see the image below). Acute focal bacterial nephritis has a lobar distribution of inflammation, wedge-shaped hypodense lesions (postcontrast), and masslike hypodense lesions in severe infections. Xanthogranulomatous pyelonephritis (see the images below, as well as Xanthogranulomatous Pyelonephritis Imaging) may have the following CT features:

  • Large kidney calculi
  • Nonfunctioning kidneys
  • Contrast enhancement around low-attenuation areas
  • Thickening of the Gerota fascia
  • Spherical areas of low attenuation
Multiple abscesses, upper pole of left kidney. Multiple abscesses, upper pole of left kidney.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!