OBJECTIVE: The present study was aimed at establishing the frequency of renal/perirenal and extrarenal computed tomography findings in patients with acute pyelonephritis, and evaluating the interobserver agreement. MATERIALS AND METHODS: Retrospective study based on the analysis of computed tomography images of 47 patients with clinical and laboratory findings of acute pyelonephritis. Two independent observers evaluated the main renal/perirenal and extrarenal alterations. The frequency of tomographic findings and interobserver agreement were analyzed by the kappa (k) test. RESULTS: The frequency of tomographic findings for the several parameters was the following: striated nephrogram, 100%; renal enlargement, 65%; perirenal fat heterogeneity, 62.5%; renal calculi, 16.6%; abscesses, 21%; pleural effusion, 36%; thickened gallbladder wall, 32.5%; periportal edema, 32.5%. The k test for interobserver agreement demonstrated reproducibility ranging between moderate (k = 0.511 for renal enlargement) to almost perfect (k = 0.87 for striated nephrogram) for all of the parameters analyzed, except for perirenal fat heterogeneity (k = 0.268). CONCLUSION: The frequency of findings of acute pyelonephritis on computed tomography is high. Overall, striated nephrogram was the most frequent finding. Peri- and extra-renal alterations were found in about 2/3 of the cases. Computed tomography demonstrated a good interobserver agreement.

Keywords: Acute pyelonephritis, Kidney, Computed tomography, Reproducibility

OBJECTIVE: The purpose of this study was to assess the performance of neutral oral contrast agents, comparing intestinal distention, distinction of intestinal wall, acceptance and side effects. MATERIALS AND METHODS: Prospective, randomized, and double-blinded study involving 30 patients who underwent computed tomography of abdomen and pelvis with administration of neutral oral contrast agents, divided into three groups according the contrast agent type: milk, water, and polyethylene glycol. The images were consensually analyzed by two observers, considering the degree of bowel distention and intestinal wall distinction. The patients responded to a questionnaire regarding the taste of the ingested solution and on their side effects. Kruskal-Wallis and chi-square tests were employed for statistical analysis. RESULTS: Among 40 studied intestinal segments, appropriate bowel distension (intestinal loop diameter > 2 cm) was observed in 14 segments (35%) in the milk group, 10 segments (25%) in the water group and 23 segments (57%) in the polyethylene glycol group (p = 0.01). Preparation with polyethylene glycol resulted in the best bowel distention, but it presented the worst taste and highest incidence of diarrhea as reported by patients. CONCLUSION: Bowel preparation with oral polyethylene glycol results in higher degree of bowel distention than with water or milk, but presents worst acceptance related to its taste and frequency of diarrhea as a side effect.

Keywords: X-ray computed tomography; Small bowel; Contrast media.

The objective of the present study is to describe key computed tomography and magnetic resonance imaging findings in patients with acute abdominal pain caused by ectopic pregnancy. For this purpose, two radiologists consensually selected and analyzed computed tomography and magnetic resonance imaging studies performed in female patients with acute abdominal pain caused by proven ectopic pregnancy in the period between January 2010 and December 2011. The imaging diagnosis of ectopic pregnancy is usually obtained by ultrasonography, however, with the increasing use of computed tomography and magnetic resonance imaging in the assessment of patients with acute abdomen of gynecological origin it is necessary that the radiologist becomes familiar with the main findings observed at these diagnostic methods.

Keywords: Acute abdomen; Ectopic pregnancy; Computed tomography; Magnetic resonance imaging.

The present study was aimed at describing key computed tomography and magnetic resonance imaging findings in patients with acute abdominal pain derived from pelvic inflammatory disease. Two radiologists consensually selected and analyzed computed tomography and magnetic resonance imaging studies performed between January 2010 and December 2011 in patients with proven pelvic inflammatory disease leading to presentation of acute abdomen. Main findings included presence of intracavitary fluid collections, anomalous enhancement of the pelvic excavation and densification of adnexal fat planes. Pelvic inflammatory disease is one of the leading causes of abdominal pain in women of childbearing age and it has been increasingly been diagnosed by means of computed tomography and magnetic resonance imaging supplementing the role of ultrasonography. It is crucial that radiologists become familiar with the main sectional imaging findings in the diagnosis of this common cause of acute abdomen.

Keywords: Acute abdomen; Pelvic inflammatory disease; X-ray computed tomography; Magnetic resonance imaging.