PMC4746850_01
The scintigraphy was performed with intravenous injection of 375 MBq of Tc-99m diethylenetriaminepentaacetic acid and F-0 injection of furosemide in the dose of 1 mg/kg. The dynamic imaging during perfusion phase revealed transit of bolus through aorta (red arrow, Figure 1), vascular blush to right kidney (blue arrow) and an intense vascular blush in region of left renal fossa at level of lower pole of kidney (black arrow)
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F1
The dynamic imaging during perfusion phase revealed transit of bolus through aorta [red arrow, Figure 1], vascular blush to right kidney (blue arrow), and an intense vascular blush in region of left renal fossa at level of lower pole of kidney (black arrow).
The uptake phase of renal scintigraphy revealed the absence of cortical uptake in left kidney and normal tracer uptake of right kidney
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F2
The uptake phase of renal scintigraphy revealed the absence of cortical uptake in left kidney and normal tracer uptake of right kidney [Figure 2]. To evaluate cause of vascular blush in left renal fossa, further evaluation with contrast-enhanced computed tomography (CECT) was performed.
(a) Precontrast coronal section shows large left renal staghorn calculus with enlarged, hydronephrotic kidney. (c) Reveals arterial phase of contrast-enhanced computed tomography, depicting arterial enhancement in the lower pole cortex of left kidney. (b) Axial section of postcontrast delayed phase at the level of lower pole cortex. Persistent parenchymal enhancement, perinephric fat stranding, and thickening of Gerota's fascia was seen (arrows). The contrast-enhanced computed tomography scan findings suggested a diagnosis of acute pyelonephritis involving lower pole of left kidney. (d) Sagittal contrast-enhanced computed tomography section shows that the perinephric fat stranding is extending inferoposterior to lower pole of left kidney
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F3
Figure 3a precontrast coronal section shows large left renal staghorn calculus with enlarged, hydronephrotic kidney. Figure 3c reveals arterial phase of CECT, depicting enhancement in the lower pole of the left kidney. Figure 3b shows axial section images of postcontrast delayed phase at the level of lower pole. Figure 3d sagittal CECT section shows that the perinephric fat stranding is extending inferoposterior to the lower pole of left kidney.