HRCT检查在泌尿系结核影像诊断与指导治疗中的应用价值  

Application value of HRCT in diagnostic imaging and therapy guidance of urinary tuberculosis

作　　者：王东[1] 陆普选[2] 袁虹[3] 邓群益[4] 李晶晶[2] 

机构地区：[1]河南大学附属南阳南石医院放射科,河南南阳473000 [2]深圳市第三人民医院放射科,广东深圳518112 [3]深圳市第三人民医院内科,广东深圳518112 [4]深圳市第三人民医院结核科,广东深圳518112

出　　处：《首都医科大学学报》2016年第4期477-480,共4页Journal of Capital Medical University

摘　　要：目的探讨36例泌尿系结核高分辨率计算机体层摄影术(high resolution computed tomography,HRCT)表现特点以及影像学在指导治疗中的价值,以期提高诊断符合率和为规范治疗提供依据。方法回顾性分析36例经病理及临床证实的泌尿系结核患者的病例资料,研究HRCT在泌尿系结核中的扫描技术、CT平扫及增强的影像学表现特点。同时评价HRCT在泌尿系结核治疗方案选择中的作用。结果1)36例泌尿系结核患者的HRCT平扫与增强中发现3例早期肾结核,表现为肾实质内小低密度病灶。2)肾内多发花瓣状低密度区25例,肾弥漫性钙化即肾自截2例,肾皮质局限萎缩变薄4例,肾萎缩10例,肾盂或肾盏壁普遍增厚4例。3例腹膜后可见多发性大小不一的淋巴结。3)HRCT平扫加增强,对病灶侵犯脏器和周围组织的范围和程度及肿大淋巴结等进行评价,据此决定手术方式和手术时间。结论肾实质内较小的低密度病灶,肾内多发花瓣状低密度区增强扫描后病变区瓣壁呈环状中度延迟强化,并有不规则钙化是肾结核的影像学特点。依据HRCT影像表现特点可为临床治疗方案的选择提供客观依据。Objective To investigate the 36 cases of urinary tuberculosis on high resolution computed tomography（ HRCT）appearances and the value of imaging in guiding therapy,and to improve the diagnostic consistency rate and provide the basis for standard treatment. Methods A retrospective analysis of 36 cases of urinary tuberculosis cases confirmed by pathology and clinical data,to study HRCT scanning technique of urinary tuberculosis,imaging findings of CT plain and enhanced scan and to evaluate HRCT in the role of urinary tuberculosis treatment options. Results（ 1） Of 36 cases of urinary tuberculosis HRCT scan and enhancement were found in 3patients with early renal tuberculosis,characterized by small low density lesions in the renal parenchyma.（ 2） In the renal multiple petal shaped low-density area in 25 cases,renal diffuse calcification that since the cut in 2 cases,renal cortical atrophy thinning in 4 cases,10 cases of renal atrophy,renal pelvis or light wall thickening in 4 cases; Three cases of retroperitoneal lymph nodes of visible multiple sizes.（ 3） The HRCT scan and enhancement,infringement on the scope and degree of viscera and the surrounding tissue to evaluate and swollen lymph nodes,according to this decision on operation mode and operation time. Conclusion renal parenchyma in smaller low-density lesions,within multiple petal shaped low-density lesions after enhancement scanning area disc wall showed cricoid moderately delayed reinforcement,and irregular calcification is the imaging characteristics of renal tuberculosis. Based on HRCT imaging performance characteristics can provide objective basis for the choice of clinical treatment.

关 键 词：泌尿系结核 X线计算机 HRCT表现 诊断/治疗 

分 类 号：R81[医药卫生—放射医学]