髓质海绵肾的影像学诊断(附13例报告)  

Imaging diagnosis of medullary sponge kidney:a report of 13 cases

作　　者：邓慧娟[1] 张玉光 刘红光[1] 

机构地区：[1]山东省胶南市人民医院CT室,山东胶南266400 [2]青岛市城阳区人民医院

出　　处：《实用医学影像杂志》2009年第2期109-111,共3页Journal of Practical Medical Imaging

摘　　要：目的研究髓质海绵肾(MSK)的影像学表现,并提高其诊断准确性。方法临床疑诊MSK的13例患者中,起先8例经X线平片检查,11例经超声检查,7例经CT平扫,其中,3例又经CT增强扫描,随后,11例经静脉肾盂造影(IVP)证实,2例经手术病理证实。对所有患者的影像表现进行了回顾性分析。结果IVP显示集合管呈线状、囊状扩张。X线平片显示肾乳头、髓质区簇状排列的圆形、椭圆形致密影。超声显示围绕肾髓质放射状分布的小回声区和强回声光点。CT平扫示环绕肾小盏分布的点状或簇状结石影,髓质区饱满、明显增大,呈低密度影,增强后,结石影周围的集合管内造影剂蓄积,造成结石影增大的假象。结论IVP是诊断本病例的金标准,但它属于有创性检查,X线平片可作为本病的首选检查方法,而CT能清楚显示肾内结石的形态、大小及分布状况,尤其是髓质增大且呈低密度是本病一新的重要征象之一。Objective To study the imaging findings of medullary sponge kidney （MSK）and to elevate the diagnostic accuracy. Methods Among 13 patients with clinicaliy suspected MSK,initially,8 cases underwent plain radiography, 11 cases underwent ultrasonography and 7 cases underwent CT plain scan,of whom,3 cases unerwent CT enhanced scan,subsequentiy,MSK of 11 cases was confirmed by intravenous pyrography （IVP）, while that of other two cases was confirmed by surgery and pathology.The imaging findings of all patients were retrospectively analyzed.Results On IVP images,MSK appeared as linear or cystiform dilatation of collective ducts.On X-ray plain films,MSK appeared as round or oblong dense shadows located in renal papillary and medullary areas.On ultrasonic images,MSK appeared as small echo areas and strength echo points with radial distribution around the medulla nephrica.On CT images without contrast enhancement,MSK appeared as small punctual or cluster-like calculi shadow around calyces renales minores, obvious enlargement of satisfied medullary areas and hypodense shadows.After enhanced CT scans,the contrast medium accumulated in the collective ducts around calculi shadows and led up to false sign of calculi shadow enlargement.Conclusion IVP is gold criterion to diagnose MSK but it is referred to invasive examination.Plain abdominal radiography can be taken as a first choice to diagnose MSK, while CT scan without and with contrast enhancement can dearly show the shape,size and distribution state of intrarenal calculi,especially,the enlargement and hypodensity of medullary area is a characteristic sign of MSK.

关 键 词：髓质海绵肾 X线平片 体层摄影术 X线计算机 

分 类 号：R445[医药卫生—影像医学与核医学] R692[医药卫生—诊断学]