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OBJECTIVE To assess the ability of power Doppler ultrasonography (PDU) to detect acute pyelonephritis and to compare the findings from PDU with those from enhanced computed tomography (CT). METHODS Eleven patients (mean age 18.5 years, range 5-37) admitted to hospital with a clinical diagnosis of pyelonephritis were assessed with PDU and enhanced CT. the latter providing the reference method. RESULTS The imaging studies showed normal findings in three patients; a single focus of pyelonephritis was detected by CT in six, whereas a matching defect was detected on PDU in five, with PDU failing to detect an infective focus in one. Multifocal diffuse pyelonephritis was diagnosed correctly by enhanced CT and PDU in two patients. CONCLUSIONS Power Doppler ultrasonography had an overall sensitivity of 88% and complete specificity in the evaluation of patients with acute pyelonephritis.
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