多排螺旋CT在肾脏融合畸形诊断中的应用  

The application of multidetector CT in diagnosis of renal fusion anomalies

作　　者：龚瑞[1] 尹姬[1] 郭玉林[1] 陈勇[1] 侯登华[1] 蔡磊[1] 

机构地区：[1]宁夏医科大学总医院放射科,宁夏银川750004

出　　处：《实用放射学杂志》2013年第11期1798-1802,共5页Journal of Practical Radiology

摘　　要：目的 探讨多排螺旋CT（MDCT）在诊断肾脏融合畸形的合理扫描方法及其临床应用.方法 回顾性分析30例肾脏融合畸形患者的临床完整资料,均行MDCT检查,其中27例行平扫加多时相分期增强扫描,1例行动脉期增强扫描,2例行静脉肾盂造影（IVP）后延时尿路造影扫描,在工作站对获取的增强及延时尿路造影扫描薄层图像行多平面重组（MPR）、容积再现（VR）及四维透明显示（4D-Raysum） 3种方法后重组.结果 30例中,马蹄肾（HS）19例,肾脏交叉异位并融合畸形（CFRE）9例,双肾异位并融合畸形1例,副肾畸形并融合1例.融合肾伴有肾盂输尿管交界狭窄6例,多支肾动脉供血11例,巨输尿管1例.并发肾盏或肾盂结石6例,输尿管下段结石1例,肾盏肾盂积水11例.1例马蹄肾合并左肾透明细胞癌,行手术病理证实.结论 应用MDCT对肾脏融合畸形进行合理方案扫描并结合多种方法后重组,可以清楚显示肾脏融合畸形的类型及并发症的发生情况,为临床提供更多的影像信息,可作为肾脏融合畸形综合影像学评价的最优检查方法.Objective To evaluate the optimum scanning and clinical application of multidetector CT （MI）CT） in the diagnosis of renal fusion anomalies. Methods 30 patients with renal fusion anomalies were underwent MDCT examination. Among them, 27 cases were performed unenhanced and multi-phase enhanced scan , only 1 case was performed arterial phase , 2 cases were performed delay urography after intravenous pyelography （IVP）. The images were transferred by network to a separate workstation to perform multiplanar reconstruction （ MPR）, volume rendering （VR} and four-dimensional transparent display （4DRaysum）. All the postsprocessing images were retrospectively analyzed. Results Among the 30 patients, 19 cases were diagnosed as horseshoe kidney （HS）, 9 cases were crossed fused renal ectopia（CFRE）, 1 case was bilateral ectopia of fused kidney, 1 case was supernumerary of fused kidney. 6 cases with ureteropelvic junction stenosis, 11 cases with multiple renal artery, 1 case with megaureter. 6 cases with complicated renal calices or pelvic stones, 1 case with lower ureteral stones, 11 cases with renal calices hydronephrosis. 1 horseshoe kidney with left renal clear cell carcinoma was confirmed by histopathological analysis after surgical resection. Conclusion The type and complications of renal fusion anomalies can be clearly demonstrated by MDCT. When combining with the optimum scanning and a variety of post-processing methods, more informations can be provided to evaluate the renal fusion anomalies.

关 键 词：计算机体层成像 融合肾 马蹄肾 先天性畸形 

分 类 号：R814.42[医药卫生—影像医学与核医学] R692.1[医药卫生—放射医学]