摘要
目的分析黄色肉芽肿性肾盂肾炎的CT表现及误诊原因，以提高对该病的认识。方法分析经手术病理证实的7例黄色肉芽肿性肾盂肾炎患者的CT表现及临床资料，观察病变形态特征、病灶密度及强化形式，伴发结石或钙化以及肾周受累情况。结果7例患者均行CT平扫加增强扫描，5例发生于左侧，2例发生于右侧。弥漫型累及全肾，肾影增大，肾盂肾盏扩大积液，肾实质内多发囊实性占位，病变分界不清，向肾外扩展，肾周间隙模糊，肾筋膜增厚并累及腰大肌，腹壁脓肿形成；局灶型表现为肾实质内局限性占位，病灶区呈略低密度灶，增强后边界清晰，病灶内见环形强化，而略低密度灶者强化较明显，但仍低于肾实质。术前误诊为肾脓肿3例，肾癌2例，肾结核1例，肾结石合并肾积水1例。结论黄色肉芽肿性肾盂肾炎由于缺乏特异性诊断征象，术前容易造成误诊。
Objective To analyze the CT manifestations of xanthogranulomatous pyelonephritis （ XGPN ）and the causes of misdiagnosis and to further understand radiological diagnosis of XGPN. Methods The CT and clinical manifestations of 7 cases of XGPN were analyzed retrospectively. And the density, enhancement and morphologic characters of the lesions , calculus, calcification and perirenal spaces were observed.All the cases were pathologically proved, Results All the 7 cases were underwent enhancement scanning. 6 cases of the 7 located in left kidney, while 1 case of 7 in the right.The diffusive XGPN shows cystic-solid multi-occupying with the whole kidney involved and kidney, renal pelvis and calices enlarged. The lesions were extensive with unclear border which made the perirenal space dim, renal fasciae thicken and with the abscess formation of psoas and abdominal wall. The localized XGPN shows mass in the renal parenchyma with low density, clear border after enhancement and rim enhancement. The lesions with slightly low density were relatively significant enhancement but lower than the renal parenchyma. Diseases were preoperatively misdiagnosed as 3 cases of renal abscess, 2 cases of renal cell carcinoma, one case of renal tuberculosis, and one case of renal calculi complicated with hydronephrosis. Conclusion As there is no significant diagnostic sign of XCPN, misdiagnosis is easily found before operation. Anyhow, CT plain scan plus enhanced scan is generally accepted as the best method now.
出处
《国际医药卫生导报》
2010年第7期826-830,共5页
International Medicine and Health Guidance News
关键词
黄色肉芽肿性肾盂肾炎
断层摄影术
Xanthogranulomatous pyelonephritis （ XGPN ）
Tomography X-ray computed
