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Shin, Sung, Park, Kim, Cho, Han, and Lee: Gallbladder Wall Thickening and Periportal Tracking on CT in Patients with Acute Pyelonephritis
Uroradiology
Journal of the Korean Society of Radiology

Journal of the Korean Society of Radiology 2012; 67(5): 381-386.

Published online: 21 November 2012

DOI: https://doi.org/10.0000/jksr.2012.67.5.381

Gallbladder Wall Thickening and Periportal Tracking on CT in Patients with Acute Pyelonephritis

Jae Shik Shin, MD, Deuk Jae Sung, MD, Beom Jin Park, MD, Min Ju Kim, MD, Sung Bum Cho, MD, Na Yeon Han, MD, Nam Joon Lee, MD

Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea.

Corresponding author: Deuk Jae Sung, MD. Department of Radiology, Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. Tel. 82-2-920-5567, Fax. 82-2-929-3796, urorad@korea.ac.kr

Received 5 June 2012       Accepted 9 August 2012

Copyright © 2012 The Korean Society of Radiology

Abstract

Purpose

To assess gallbladder (GB) wall thickening and periportal tracking on CT in patients with acute pyelonephritis (APN) by each kidney involvement.

Materials and Methods

A total of 117 patients diagnosed with APN by clinical examination and CT were included in this retrospective study. The patients were divided into three groups based on kidney involvement seen on CT: right APN, left APN, and bilateral APN. Two radiologists reviewed CT images in consensus for the presence of diffuse GB wall thickening and periportal tracking. The prevalence of these two manifestations was compared among the three groups.

Results

The prevalence of GB wall thickening in patients with right APN (26.4%) and bilateral APN (19%) was significantly higher than in patients with left APN (0%) (p < 0.016). The prevalence of periportal tracking in patients with right APN (15.1%) and bilateral APN (26%) was higher than in patients with left APN (3%), with a significant difference between patients with bilateral APN and left APN (p < 0.016).

Conclusion

GB wall thickening and periportal tracking are predominantly encountered on CT in patients with APN involving the right kidney (right and bilateral APN), and should be considered in differential diagnosis of diseases associated with GB wall thickening and periportal tracking.

Keywords: Acute Pyelonephritis, Gallbladder Wall Thickening, Periportal Tracking, CT

Figures and Tables

Fig. 1
A 36-year-old woman with fever and bilateral flank pain.
A. Axial contrast-enhanced CT scan demonstrates wedge shaped hypoattenuating area within the bilateral kidneys (arrows), features consistent with bilateral APN.
B, C. CT scans show thick-walled GB that contains hypodense outer layer corresponding to subserosal edema (arrow in B) and periportal tracking (arrows in C) in the liver.
Note.-APN = acute pyelonephritis, GB = gallbladder
jksr-67-381-g001
Fig. 2
A 22-year-old woman with right flank pain.
A. Axial contrast-enhanced CT scan demonstrates wedge shaped hypoattenuating area within right kidney (arrow), features consistent with right APN.
B, C. CT scans show edematous GB wall thickening (arrow in B) and periportal tracking (arrow in C) in the liver.
Note.-APN = acute pyelonephritis, GB = gallbladder
jksr-67-381-g002
Table 1
Prevalence of Gallbladder Wall Thickening and Periportal Tracking according to APN Involvement of Each Kidney
jksr-67-381-i001

Note.-APN = acute pyelonephritis

Table 2
Multiple Comparisons of the Prevalence of Gallbladder Wall Thickening and Periportal Tracking among Three Groups
jksr-67-381-i002

Note.-APN = acute pyelonephritis

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