Abstract
There are many acute and chronic infections affecting the urinary tract including bacterial, fungal and viral infections. Urinary tract infections (UTIs) can present in many different patterns with variable degrees of severity varying from asymptomatic and uncomplicated forms to life threatening complicated infections. Cross-sectional imaging techniques—including both computed tomography (CT) and magnetic resonance imaging (MRI)—have become very important tools not only for evaluation of UTIs, but also for detection of associated complications. Selection of either CT or MRI in the UTI evaluation depends on several factors such as the presence of contraindication, experience, cost and availability. CT and MRI help in early detection and management of UTIs that reduce the prevalence and severity of complications. In this article we will present the radiologic findings at CT and MRI in different types of upper and lower UTIs including acute pyelonephritis, intrarenal and perinephric abscesses, pyonephrosis, chronic pyelonephritis, emphysematous UTIs, xanthogranulomatous pyelonephritis, tuberculosis (TB), bilharziasis, fungal infection, corynebacterium infection, ureteritis, cystitis, prostatitis, prostatic abscess and urethritis.
Highlights
Worldwide, urinary tract infection (UTI) is considered the commonest urologic problem, affecting about 150 million patients annually [1]
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Diffusion-weighted imaging (DWI) can diagnose pyelonephritis based on renal parenchymal apparent diffusion coefficient (ADC) values, which are usually found to be lower than those of the unaffected renal parenchyma [11,18,19]
Summary
Urinary tract infection (UTI) is considered the commonest urologic problem, affecting about 150 million patients annually [1]. Diagnostic imaging for evaluation of UTI is mandatory in the following conditions:. CT is the ideal imaging modality in the assessment of most cases of UTI as it is a fast technique and provides adequate anatomical and physiological details, identifies both renal and extra-renal pathologies, and provides different phases to be evaluated after intravenous contrast injection. Diffusion-weighted imaging (DWI) can diagnose pyelonephritis based on renal parenchymal apparent diffusion coefficient (ADC) values, which are usually found to be lower than those of the unaffected renal parenchyma [11,18,19]. MRI is ideal for detection of complications related to UTIs such as renal abscess and to follow up the response to medical treatment and percutaneous drainage, especially in young patients. The role of MRI will be highlighted in the diagnosis of UTIs and associated complications, especially when there is a contraindication to CT
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