黄色肉芽肿性肾盂肾炎的CT影像诊断及病理分析  

CT Image Diagnosis and Pathological Analysis of Xanthogranulomatous Pyelonephritis

作　　者：刘晓霞[1] 翟曜耀 卢再鸣[1] LIU Xiaoxia;ZHAI Yaoyao;LU Zaiming(Department of Radiology,Shengjing Hospital of China Medical University,Shenyang,Liaoning Province 110004,P.R.China)

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110004 [2]北部战区总医院耳鼻咽喉头颈外科,沈阳110016

出　　处：《临床放射学杂志》2021年第5期941-944,共4页Journal of Clinical Radiology

摘　　要：目的分析黄色肉芽肿性肾盂肾炎(XGP)的CT影像表现、病理特点及其鉴别诊断。方法回顾性分析26例术后病理证实为XGP患者的CT影像表现,术前均行CT平扫及增强扫描。结果 26例患者均为单侧发病,10例局限型,16例弥漫型,CT平扫显示为肾实质内局限或弥漫性囊实性或囊性肿块,多数伴肾盂结石或近端输尿管结石;肾周脂肪密度增加,肾周筋膜增厚,肾旁间隙散在渗出、渗液;增强扫描实性部分及囊壁持续强化,囊性部分不强化,多数患侧肾脏灌注减低。病理学以大量"泡沫样"巨噬细胞、组织细胞等形成的肉芽肿样结构为主,伴炎性细胞浸润及纤维组织增生。结论增强CT对于XGP的诊断和鉴别诊断有明显价值。Objective To analyze the CT imaging manifestations, pathological features and differential diagnosis of xanthogranulomatous pyelonephritis(XGP). Methods A retrospective analysis of the CT imaging manifestations of 26 patients with XGP confirmed pathologically after the operation was performed. All CT scans and enhanced scans were performed before the operation. Results The 26 patients had unilateral disease, 10 were localized and 16 were diffuse. CT scan showed localized or diffuse cystic or cystic masses in the renal parenchyma, most of which were accompanied by renal pelvic stones or proximal ureteral stones. The density of perirenal fat increased, and the perirenal fascia thickened, the perinephric space was scattered with exudate. On enhanced CT scan, the solid part and the wall enhanced continuously, but the cystic part was not enhanced, the perfusion of the affected kidney was decreased.Inpathology, there were granulomatous structures formed by a lot of foam-like macrophages and histiocytes, with inflammatory cell infiltration and fibrous tissue hyperplasia. Conclusion Enhanced CT is of great value in the diagnosis and differential diagnosis of XGP.

关 键 词：黄色肉芽肿性肾盂肾炎 体层摄影术 X线计算机 影像诊断 病理 

分 类 号：R692.3[医药卫生—泌尿科学]