Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Nov 28, 2014; 6(11): 865-873
Published online Nov 28, 2014. doi: 10.4329/wjr.v6.i11.865
Multimodality imaging of renal inflammatory lesions
Chandan J Das, Zohra Ahmad, Sanjay Sharma, Arun K Gupta
Chandan J Das, Zohra Ahmad, Sanjay Sharma, Arun K Gupta, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi 110029, India
Author contributions: All the authors solely contributed to this paper.
Correspondence to: Sanjay Sharma, MD, Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar East, Gautam Nagar, New Delhi, Delhi 110029, India.
Telephone: +91-98-11687277 Fax: +91-98-11687277
Received: April 3, 2014
Revised: August 19, 2014
Accepted: September 6, 2014
Published online: November 28, 2014

Spectrum of acute renal infections includes acute pyelonephritis, renal and perirenal abscesses, pyonephrosis, emphysematous pyelonephritis and emphysematous cystitis. The chronic renal infections that we routinely encounter encompass chronic pyelonephritis, xanthogranulomatous pyelonephritis, and eosinophilic cystitis. Patients with diabetes, malignancy and leukaemia are frequently immunocompromised and more prone to fungal infections viz. angioinvasive aspergillus, candida and mucor. Tuberculosis and parasitic infestation of the kidney is common in tropical countries. Imaging is not routinely indicated in uncomplicated renal infections as clinical findings and laboratory data are generally sufficient for making a diagnosis. However, imaging plays a crucial role under specific situations like immunocompromised patients, treatment non-responders, equivocal clinical diagnosis, congenital anomaly evaluation, transplant imaging and for evaluating extent of disease. We aim to review in this article the varied imaging spectrum of renal inflammatory lesions.

Keywords: Imaging modalities, Renal infection, Cystitis, Pyelonephritis, Pyonephrosis, Xanthogranulomatous, Magnetic resonance imaging

Core tip: Imaging in renal infections is challenging, given the relatively non-specific nature of findings in majority of the cases. A careful assessment of clinical situation in question is essential to accurately choose the imaging modality which would provide most information. In this review we discuss the appropriateness of specific imaging modalities, to allow the radiologist to choose the best modality for a given clinical situation. In addition, some entities such as acute pyelonephritis, Xanthogranulomatous pyelonephritis and emphysematous pyelonephritis have some specific imaging features. In this review we describe and illustrate such specific features, to facilitate their recognition when present.