Role of gadolinium enhanced MRI and DWI in diagnosis of renal abscess in children

Abstract

INTRODUCTION: Renal abscess is a localized collection of infected fluid in kidneys. It develops as a complication of focal pyelonephritis or hematogenous infection, when inflammation may occasionally result in liquefactive necrosis and abscess formation. MRI is increasingly important pediatric imaging modality because of great spatial resolution and sparing patients from potential risks of ionizing radiation exposure, especially children and adolescents PURPOSE: The purpose of this article is to present a case report of 10 years old child with renal abscess, diagnosed by MRI. MATERIALS AND METHODS: We present a 10 years old female with symptoms of fever, left flank pain, dysuria, vomiting and fatigue 5 days before examination. Blood tests shows leukocytosis and bacteria and leukocytes were present in urine. CT and US was performed previously, but were inconclusive. MR was used to confirm the diagnosis. 1.5 Siemens Avanto scanner was used with whole body MRI coil exploited. Standard MRI abdominal examination involved T1 and T2 weighted pulse sequences, Fat Sat technique, DWI and SPC 3D sequence and post Gadolinium T1 sequences. RESULTS: MRI confirmed a renal abscess formation in upper pole of left kidney, especially DWI and postcontrast T1 sequence. DW and corresponding ADC map show that the lesion has restricted diffusion with thin walled post Ga enhancement. Lesion has drained in perirenal space and collecting system. CONCLUSION: MRI is increasingly important pediatric imaging modality because of great spatial resolution and sparing patients from potential risks of ionizing radiation exposure, especially children and adolescents.