Papanicolaou N, Pfister R C
Cornell University Medical College, New York, New York, USA.
Radiol Clin North Am. 1996 Sep;34(5):965-95.
Most adults with uncomplicated acute pyelonephritis pose no diagnostic or therapeutic problems and recover fully. When imaging is requested in these cases, CT scan with and without contrast enhancement is preferable; however, depending on the condition of the patient and preference of the clinician an IVU, sonogram, or radionuclide scan may also provide adequate information. Patients at higher risk for complications, such as renal or perinephric abscesses with or without PHN and EPN, require aggressive and vigorous clinical and radiologic monitoring. CT scan is superior to other imaging modalities in the investigation of these complications. Interventional percutaneous procedures are established as safe and effective means of controlling or curing the infection in many patients and are often chosen over traditional surgical technique. The radiologist thus is an indispensable member of the management team and should be available for consultation and intervention.
大多数患有非复杂性急性肾盂肾炎的成年人不存在诊断或治疗问题，且可完全康复。对于这些病例，如需进行影像学检查，增强和未增强的CT扫描更佳；然而，根据患者情况和临床医生的偏好，静脉肾盂造影、超声检查或放射性核素扫描也可能提供足够的信息。发生并发症风险较高的患者，如伴有或不伴有肾周和肾周脓肿的肾盂肾炎和肾痈，需要积极且严格的临床和放射学监测。在这些并发症的检查中，CT扫描优于其他影像学检查方式。介入性经皮操作已被确立为控制或治愈许多患者感染的安全有效手段，并且通常比传统手术技术更受青睐。因此，放射科医生是管理团队中不可或缺的成员，应随时提供咨询和干预。
