D Ultrasonography shows a heterogeneous hyperechoic cyst with internal septation arrow. Fig 2. US images used as procedure guidance were available for 41 episodes in 37 patients. Escherichia coli accounted for 18 This is an open access article distributed under the terms of the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Among a total of episodes, the episodes that met all three of the following criteria were included for CT features analysis in infected cysts: 1 the patient should have been undergone percutaneous catheter drainage PCD or aspiration for suspected infected cysts, 2 pre-procedural abdominal CT images should have been obtained less than 1 week before PCD or aspiration, and 3 histological reports of cyst fluid are available. Results Clinical characteristics Among 51 episodes, 25 patients had 31 episodes of renal cyst infection, and 18 patients had 20 episodes of hepatic cyst infection. On US images, intracystic echogenicity was classified into anechoic versus echoic type.
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In conclusion, minute findings such as minimal wall thickening, pericystic fat infiltration, or relatively higher attenuation compared to normal cysts could be suggestive of infected cyst in ADPKD patients.
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Note: Perilesional hyperemia is evaluated only in hepatic cyst. Table 1 summarizes the demographic and clinical information. National Center for Biotechnology InformationU. Intracystic attenuation HU of infected cysts and presumed normal cysts.
However, the pre-contrast scan also has value because several features, such as relatively high or heterogeneous attenuation and the presence of intracystic gas, can be evaluable on CT without enhancement. Infected cysts also appeared to have relatively high attenuation compared to the surrounding normal cysts in 34 of 43 episodes
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|Probability P value less than 0.
Efficacy of diffusion-weighted magnetic resonance imaging in detecting infected cysts in a case of polycystic kidney disease. Fig 7. Cyst infection in hospital-admitted autosomal dominant polycystic kidney disease patients is predominantly multifocal and associated with kidney and liver volume. BMC public health. Heterogeneous echogenicity was found in 22 homogeneously attenuating cysts; conversely, there was no homogeneously echoic cyst that showed heterogeneous attenuation.
Balbo BE, Sapienza MT, Ono CR, Jayanthi SK, Dettoni JB, Castro I, et al. Clinical features of cyst infection and hemorrhage in ADPKD: new diagnostic criteria. Gilbertson DT, Liu J, Xue JL, Louis TA, Solid CA, Ebben JP, et al.
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In our study, 22 infected cysts with homogeneous attenuation on CT showed heterogeneous echogenicity on US, indicating that US can demonstrate intracystic complicated fluid content more sensitively.
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On US images, intracystic echogenicity was classified into anechoic versus echoic type. Enhancement-related evaluation On post-contrast CT images, 37 of 51 Efficacy of diffusion-weighted magnetic resonance imaging in detecting infected cysts in a case of polycystic kidney disease. With regard to intracystic attenuation, a relatively high attenuation based on the visual perception by the reviewer was a common feature in infected cysts.
CT features of infected cysts investigated in this study are not specific and could be seen in hemorrhagic cysts or infrequently in cysts with sterile inflammation. Fig 2.
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The New England journal of medicine. However, it is challenging to detect infected cysts in ADPKD patients with numerous cysts in the kidney or liver. There was no episode that was positive only in the urine culture.
To compare attenuation difference between an infected and normal cyst, attenuation was measured in two presumed normal cysts that showed no discernible wall, water attenuation, and no evidence of perilesional inflammation.
Table 4 Attenuation of infected cysts and presumed normal cysts.
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|The median attenuation value of the 36 infected cysts was PLoS One.