What is the role of MRI in the evaluation of acute pyelonephritis (kidney infection)?

Updated: Jul 01, 2021
  • Author: Tibor Fulop, MD, PhD, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Magnetic resonance imaging (MRI) can detect kidney infection or masses and urinary obstruction, and it can evaluate the kidney vasculature. American College of Radiology Appropriateness Criteria list CT, MRI, and ultrasound as the primary imaging modalities used in patients with acute pyelonephritis. [17]

A study of diffusion-weighted MRI found that MRI had higher sensitivity than CT (with or without contrast) for the diagnosis of acute pyelonephritis, and could differentiate areas of nephritis and kidney abscesses. However, MRI was less useful than CT for the diagnosis of kidney calculi and emphysematous pyelonephritis. [18]

As there is no radiation exposure, MRI can be used in pregnancy. [19] The cost and availability of MRI remain concerns, however. [19]

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