J Korean Soc Radiol.  2012 Nov;67(5):381-386. 10.3348/jksr.2012.67.5.381.

Gallbladder Wall Thickening and Periportal Tracking on CT in Patients with Acute Pyelonephritis

• Shin JS
• Sung DJ
• Park BJ
• Kim MJ
• Cho SB
• Han NY
• Lee NJ

• KMID: 1819753
• DOI: http://doi.org/10.3348/jksr.2012.67.5.381

Abstract

PURPOSE
To assess gallbladder (GB) wall thickening and periportal tracking on CT in patients with acute pyelonephritis (APN) by each kidney involvement.
MATERIALS AND METHODS
A total of 117 patients diagnosed with APN by clinical examination and CT were included in this retrospective study. The patients were divided into three groups based on kidney involvement seen on CT: right APN, left APN, and bilateral APN. Two radiologists reviewed CT images in consensus for the presence of diffuse GB wall thickening and periportal tracking. The prevalence of these two manifestations was compared among the three groups.
RESULTS
The prevalence of GB wall thickening in patients with right APN (26.4%) and bilateral APN (19%) was significantly higher than in patients with left APN (0%) (p < 0.016). The prevalence of periportal tracking in patients with right APN (15.1%) and bilateral APN (26%) was higher than in patients with left APN (3%), with a significant difference between patients with bilateral APN and left APN (p < 0.016).
CONCLUSION
GB wall thickening and periportal tracking are predominantly encountered on CT in patients with APN involving the right kidney (right and bilateral APN), and should be considered in differential diagnosis of diseases associated with GB wall thickening and periportal tracking.

MeSH Terms

Consensus
Diagnosis, Differential
Gallbladder
Humans
Kidney
Prevalence
Pyelonephritis
Retrospective Studies
Track and Field

Figure

• 

  Fig. 1 A 36-year-old woman with fever and bilateral flank pain. A. Axial contrast-enhanced CT scan demonstrates wedge shaped hypoattenuating area within the bilateral kidneys (arrows), features consistent with bilateral APN. B, C. CT scans show thick-walled GB that contains hypodense outer layer corresponding to subserosal edema (arrow in B) and periportal tracking (arrows in C) in the liver. Note.-APN = acute pyelonephritis, GB = gallbladder

• 

  Fig. 2 A 22-year-old woman with right flank pain. A. Axial contrast-enhanced CT scan demonstrates wedge shaped hypoattenuating area within right kidney (arrow), features consistent with right APN. B, C. CT scans show edematous GB wall thickening (arrow in B) and periportal tracking (arrow in C) in the liver. Note.-APN = acute pyelonephritis, GB = gallbladder

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