PMC7280440_01
Ultrasound and contrast-enhanced computed tomography (CT). (A) Ultrasound at first visit (Day 1): a 1-cm low echo cyst-like region in the right kidney (arrowhead). (B) First contrast-enhanced CT (Day 36): the kidney is enlarged. Poorly enhanced masses with enhanced borders were found in both kidneys (arrowhead). Two to three patchy poorly contrasted areas were found in both kidneys, but it was difficult to identify if they were cysts or infectious lesions (arrow).
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F1
Ultrasound revealed no specific findings except for a low echoic region in the right kidney, suggesting a simple renal cyst (Figure 1A). Contrast CT showed enlargement of both kidneys and enhanced borders of localized poor contrast areas (Figure 1B); however, there were no findings suggestive of other causes of fever.
Magnetic resonance imaging (Day 60). (A) T2-weighted images: 2-mm high-signal small patchy shadows were found in both kidneys (arrow). (B) T2-weighted images: thick walls in the right kidney as low signals and mass as high signals were found in the interior (arrowhead). (C) Diffusion-weighted images: masses as high-signal areas of thick-walled structures at the same site as (B) (arrowhead). (D) Apparent diffusion coefficient (ADC) map: low-signal mass at the same site as (B) (arrowhead).
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F2
T2-weighted images for both kidneys (Figure 2A) with low signal appearance T1-weighted images. The right kidney had thick-walled structures on T2-weighted image and diffusion-weighted imaging (DWI), which were visible as a low-signal mass on apparent diffusion coefficient (ADC) map (Figures 2B-D).
Magnetic resonance imaging (Day 428). (A) Diffusion-weighted images showed that the mass with high-signal areas of thick-walled structures disappeared (arrowhead). (B) Low-signal masses are also not visible on apparent diffusion coefficient (ADC) map (arrowhead).
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F3
Follow-up MRI at 11/2 years showed that the thick-walled structures with high signals on DWI had disappeared (Figure 3).
Timeline of the case. ADPKD, autosomal dominant polycystic kidney disease; MRI, magnetic resonance imaging; CT, computed tomography.
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F4
T2-weighted images of both kidneys. The timeline of this case is shown in Figure 4.