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1. Acute pyelonephritis

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Figure 47-1

Acute pyelonephritis.

A longitudinal sonographic image of a febrile 6-year-old child shows hyperechogenicity and loss of corticomedullary differentiation in the upper pole. There is slight enlargement of the involved portion of the kidney.

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2. Acute pyelonephritis

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Figure 47-2

Acute pyelonephritis.

A longitudinal sonographic image of a 9-month-old infant shows urothelial thickening (arrows) along the renal pelvis. There is mild collecting system dilation. Debris is visible floating in the urine. There is abnormal increased echogenicity of the renal parenchyma. Corticomedullary differentiation is lacking.

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3. Acute pyelonephritis

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Figure 47-3

Acute pyelonephritis.

A, B. Longitudinal and transverse sonographic images of the right kidney show abnormal hyperechogenicity in the upper pole (arrow), with lack of visualization of pyramids. C. There is diminished perfusion in the edematous upper pole on this color Doppler image.

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4. Acute pyelonephritis

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Figure 47-4

Acute pyelonephritis.

There is diminished perfusion to the infected upper pole of the right kidney on this longitudinal sonographic image.

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5. Lobar nephronia

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Figure 47-5

Lobar nephronia.

The upper pole of the kidney is echogenic and enlarged (arrows) on this longitudinal sonographic image of a 12-year-old girl with fever and flank pain.

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6. Acute pyelonephritis

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Figure 47-6

Acute pyelonephritis.

DMSA scintigraphy shows a defect in the upper pole of the right kidney, due to acute infection. (Posterior, right posterior oblique, and posterior pinhole projections.)

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7. Acute pyelonephritis

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Figure 47-7

Acute pyelonephritis.

CT shows a wedge-shaped focus of deficient contrast enhancement in an infected right kidney.

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8. Acute pyelonephritis

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Figure 47-8

Acute pyelonephritis.

There is heterogeneous deficiency of contrast enhancement throughout the enlarged right kidney.

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9. Acute pyelonephritis, bilateral

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Figure 47-9

Acute pyelonephritis, bilateral.

A CT image obtained 15 minutes after contrast injection shows regions of parenchymal contrast retention in both kidneys.

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10. Acute pyelonephritis

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Figure 47-10

Acute pyelonephritis.

A 10-minute delayed image shows retention of contrast in ...

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