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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2013; 23(01): 64-77
DOI: 10.4103/0971-3026.113617
ORIGINAL ARTICLE

Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part II

Suleman Merchant
Department of Radiology, LTM Medical College and LTM General Hospital, Mumbai
,
Alpa Bharati
Department of Radiology, LTM Medical College and LTM General Hospital, Mumbai
,
Neesha Merchant
Department of Radiology, University Health Network, University of Toronto, Toronto
› Author Affiliations Source of Support: Nill.
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Abstract

This article reviews the computed tomography and magnetic resonance imaging (MRI) features of renal tuberculosis (TB), including TB in transplant recipients and immunocompromised patients. Multi detector computed tomography (MDCT) forms the mainstay of cross-sectional imaging in renal TB. It can easily identify calcification, renal scars, mass lesions, and urothelial thickening. The combination of uneven caliectasis, with urothelial thickening and lack of pelvic dilatation, can also be demonstrated on MDCT. MRI is a sensitive modality for demonstration of features of renal TB, including tissue edema, asymmetric perinephric fat stranding, and thickening of Gerota′s fascia, all of which may be clues to focal pyelonephritis of tuberculous origin. Diffusion-weighted MR imaging with apparent diffusion coefficient (ADC) values may help in differentiating hydronephrosis from pyonephrosis. ADC values also have the potential to serve as a sensitive non-invasive biomarker of renal fibrosis. Immunocompromised patients are at increased risk of renal TB. In transplant patients, renal TB, including tuberculous interstitial nephritis, is an important cause of graft dysfunction. Renal TB in patients with HIV more often shows greater parenchymal affection, with poorly formed granulomas and relatively less frequent findings of caseation and stenosis. Atypical mycobacterial infections are also more common in immunocompromised patients.

Keywords

Diffusion-weighted imaging - lobar caseation - magnetic resonance - multidetector computed tomography - renal TB


Publication History

Article published online:
04 October 2021

© 2013. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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