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| Sonographic Findings of Xanthogranulomatous Pyelonephritis |
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| Jongchul Kim |
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| Department of Diagnostic Radiology, College of Medicine Chungnam National University Hospital |
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| PURPOSE : To analyze ultrasonographic (US) findings of xanthogranulomatous pyelonephritis (XGP).
MATERIALS and METHODS : Thirty-five cases of pathologically proven XGP in 32 patients (bilateral in three patients)
were analyzed for preoperative US findings. Compared with findings of computed tomography (CT) and
pathology, US findings were retrospectively analyzed for the appearance and size of the kidney, extent & pattern
of the disease, and presence & characteristics of calculi, by three radiologists who made a consensus.
RESULTS : Of 32 patients, 30 (94%) except two children were older than 27 years, and 25 (78%) were female. The
mean age of the patients was 46 (range 3 to 62 years). Of 35 cases in 32 patients, US appearance of the kidney
was reniform in all cases, with nephromegaly in 26 (74%) and hydronephrosis 27 (77%). XGP was diffuse in 28
(80%) and focal in 7 (20%). Hypoechoic or anechoic inflammatory lesions of XGP were found on US in 28 cases,
but the lesions were not detected on US due to the echo pattern similar to the normal renal parenchyma in two
cases and due to marked acoustic shadowing of staghorn calculi in five cases. Acoustic shadowing of renal
calculi was minimal due to the dense peripelvic fibrosis in two cases. Of 21 cases with the extrarenal extension
of XGP, the extrarenal extension was not definitely detected in five cases (24%) on US. Urinary calculi were detected
in 20 (71%) of 28 cases on US. All of the 12 staghorn calculi were detected in US.
CONCLUSION : XGP had variable US findings in addition to the classic ones. Absence of calculi, nephromegaly or diffusibility
may be found on US of XGP. In spite of advantages of US, US also had some limitations in the evaluation
of renal function, extrarenal extension, and renal parenchyma with large staghorn stone. CT and excretory
urography may compensate for these US limitations. |
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| Keyword : Kidney, Inflammation |
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pdf파일 : 265김종철.pdf 
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> Journal > Journal Search 
Journal of Korean Society of Ultrasound in Medicine 2000 ; 19 (4) : p.265-271
