METHOD FOR SELECTING THERAPEUTIC APPROACH TO ACUTE PURULENT PYELONEPHRITIS BY RESULTS OF PERFUSION COMPUTED TOMOGRAPHY Russian patent published in 2024 - IPC A61B6/03 A61B5/265 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to urology and X-ray diagnostics, and can be used to select a therapeutic approach to acute purulent pyelonephritis by determining indications for conservative therapy or surgical intervention. Perfusion computed tomography of kidneys is performed with the following parameters: slice thickness 0.5 mm in soft tissue reconstruction mode, tube voltage 80 kV, exposure 100 mAs, maximum width 160 mm, collimator dimensions 0.5 mm × 320 mm, matrix dimensions 512 × 512 mm, field of view 320–350 mm and tube rotation time 0.5 s. Blood flow velocity (AF), blood volume (BV) and capillary permeability (FE) in the cortex and medulla of the kidney are measured. With a decrease from the norm in the cortical layer of the kidney AF by 11% or less and FE by 11% or less, and in a medulla with a decrease in AF by 4% and less with a decrease in FE by 30% or less with a normal volume of blood filling in both layers, the standard conservative therapy of acute pyelonephritis is considered to be indicated. With a decrease from the norm in the cortical layer of the kidney AF by 45–71% and FE by 64–66%, and in a medulla with a decrease in AF by 6–62% and a decrease in FE by 31–53% with a normal volume of blood filling in both layers, retroperitoneoscopic excision of destructive foci and local intra-arterial rheological therapy are considered to be indicated. If observing a decrease of AF from the norm in the cortical layer of kidney by 72% or more, a decrease in BV by 75% or more, a decrease in FE by 67% or more, and in the medullary layer, by a decrease in AF by 63% or more, a decrease in BV by 83% and more and a decrease in FE by 54% and more, removal of the kidney is considered to be indicated.

EFFECT: method provides non-invasive choice of tactics of treatment of acute purulent pyelonephritis due to quantitative assessment of renal function.

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