IMAGING AND INTERVENTION IN RENAL AND PERINEPHRIC INFECTIONS

Urinary tract infection is a common medical disorder with a wide range of clinical presentations. In the majority of patients, the clinical diagnosis does not require imaging studies, and antibiotic therapy is successful. Those patients who have more complex initial presentations or who fail to improve with initial therapy benefit from radiologic i maging. The goals of this investigation are to define the level and ex tent of infection, exclude urine flow obstruction, evaluate the perine phric and retroperitoneal areas for extension of infection, define abs cess formation, exclude concurrent disease, and follow these processes to resolution. Current imaging modalities facilitate percutaneous int erventional techniques which better define the nature and extent of th e infectious process, prevent functional and surgical loss of renal pa renchyma, and expedite healing following abscess drainage. While the b enefits of percutaneous radiologic management of intra-peritoneal absc esses has been widely accepted by surgeons and other referring clinici ans, renal and perinephric infectious processes are less frequent and, thus, radiologist involvement is less common This article reviews the imaging of urinary tract infections and presents techniques to assist in the interventional radiologic management of complicated renal and perinephric infections.