肾结核的CT诊断  

CT Diagnosis of Renal Tuberculosis

作　　者：全昌斌[1] 贾树林[1] 由昆[1] 姚光大[2] 常宏伟 

机构地区：[1]解放军309医院放射科,北京100091 [2]解放军309医院病理科,北京100091

出　　处：《中国医学影像学杂志》2000年第4期262-264,共3页Chinese Journal of Medical Imaging

摘　　要：目的 :探讨肾结核CT扫描的影像特征及其鉴别诊断。材料与方法 :分析经手术病理证实或临床综合诊断的 69例肾结核的CT表现。结果 :CT反映肾结核病理特征常有 :( 1)肾髓质多发空洞或脓腔形成 ( 88 4% ) ,常呈囊状低密影并围绕肾盂似“花瓣状”排列 ;( 2 )肾皮质局部或普遍萎缩变薄 ( 78 3 % ) ;( 3 )肾盂及输尿管壁普遍增厚 ( 65 2 % ) ,管腔狭窄或扩张 ;( 4 )自髓质空洞壁逐渐出现的点线、蛋壳、球形或肾形钙化 ( 3 4 8% )。而肾脏的体积增大或缩小、外形分叶、积水或积脓及功能损害是常见的继发改变。髓质肾结核常常先侵犯肾上极 ,再继续波及全肾。结论 :CT对肾结核的诊断及制定治疗方案具有重要价值 ,熟悉CT表现并密切结合临床是正确诊断的关键。Purpose: To evaluate CT features and the differential diagnostic value of CT scan in renal tuberculosis. Materials and methods: The CT manifestations of 69 patients with proven renal tuberculosis were retrospectively analyzed and correlated with pathologic findings. Results: The common characteristic CT features included: 1) formation of multiple tuberculous cavities or abscesses in the medulla (88.4%), which often appeared the low density areas in the range of water and arranged in petal like around the pelvis. 2) focal or diffuse cortical thinning (78.3%). 3) thickening of the wall of the renal pelvis or ureter with stricture or dilatation of lumina (65.2%). 4) developing calcification of caseous material from the cavity wall to the inside (34.8%), whose pattern included punctuate, egg shell, ball or the entire kidney. But enlargement or atrophy, lobulation, functional damage of the kidney and hydronephrosis were all the common secondary CT appearences. Conclusion: CT can well demonstrate various pathologic changes of renal tuberculosis and has important value in the diagnosis and treatment. The key of diagnosis is paying attention carefully and combining with the clinical matters.

关 键 词：肾结核 CT 病理学 诊断 

分 类 号：R816.7[医药卫生—放射医学] R527.104[医药卫生—临床医学]