급성신우신염에서 신장 전산화단층촬영의 유용성

We carried out a prospective study with three aims:(1) to observe the renal computed tomography (CT) patterns in APN; (2) to compare the radiological imaging techniques used for the diagnosis of APN(renal CT and DMSA scintigraphy); (3) to correlate the clinical manifestations with CT findings in APN. Between 1 April 1997 and 31 March 1998, all adults who were admitted to our internal medicine ward with APN were included in this study. They presented with symptoms and signs of upper UTI, accompanied by pyuria and bacteriuria. All patients with renal abscess, or uropathy on the ultrasound (US) examination, were excluded from the study. 23 cases of APN were evaluated. There were 22 females and 1 male. The mean age of 23 cases was 45±19 years old(from 20 to 79 years old). Two cases we re diabetics. On the basis of postcontrast- enhanced CT findings, 23 cases were grouped into (1) Group Ⅰ(6 cases), no abnormal lesions; (2) Group Ⅱ(13 cases), wedge-shaped lesions (focal or diffuse); (3) Group Ⅲ(2 cases), focal mass-like lesions; and (4) Group Ⅳ(2 cases), diffuse mass-like lesions. The incidences of CT and DMSA scintigraphy abnormalities were 74%(17/23) and 68%(13/19), respectively. A significant correlation was demonstrated between the clinical parameters(including duration of flank pain and fever, ESR, serum creatinine, and degree of pyuria) and the pattern of renal parenchymal findings detected on CT(P<0.05). In conclusion, we classify APN into four subgroups according to CT findings, and suggest that renal CT is useful in the diagnosis and assessment of severity of APN.