摘要
目的 总结儿童多囊性肾发育不 良的影像学表现及CT诊断价值。方法 收 集我省2010年1月至2016年7月收治的经临 床及影像学证实的MCDK患儿16例作为研究 对象展开回顾性分析,对患儿的检查方法 及影像学表现进行总结。结果 CT平扫可 见肾脏呈葡萄串状低密度影,由大小不 等、数量不一的囊腔构成,囊肿间有不相 通的分隔。增强扫描囊肿未强化,间隔中 度强化,延迟扫描对比剂未进入囊内。 MRI扫描患肾内均可见较多T1WI呈低信 号、T2WI呈高信号的囊状影,囊壁及分隔 显示清晰,囊肿T1WI、T2WI均呈等信号; MRU示患肾呈多个大小不等的孤立囊性高 信号影,囊间不互通。静脉肾盂造影检查 患肾均未显影。结论 MCDK的CT和MRI均有 明显影像学特征,CT增强扫描利于良好显 示发育不良的小肾脏,囊壁及分隔等实质 部分可见中度强化,基本可诊断该病。
Objective To summarize the imaging findings of children with multicystic dysplastic kidney and evaluate the diagnostic value of CT. Methods The clinical data of 16 children with clinical and imaging confirmed MCDK treated in our hospital between January 2010 and July 2016 were analyzed retrospectively. The examination methods and imaging findings were summarized. Results CT plain scan showed that there was grape cluster-like low density shadow in kidney, composed of unequal size and different number of cysts and there was not communicated separation between cysts. Enhanced scan showed that there was no enhancement of cyst, moderate enhancement of separation. Delayed scan showed that the contrast agent did not enter the capsule. MRI scanning showed that in kidney, there were many low signals on T1WI, high signal cystic shadow on T2WI. The cystic wall and separation were clearly displayed. There were equal signals on both cyst T1WI and T2WI. MRU showed that the kidney of patient displayed a number of different sizes of isolated cystic high signal shadow, and there was no exchange between capsules. Intravenous renal pelvis radiography examination showed that the kidneys were not developed. Conclusion CT and MRI of MCDK have obvious imaging characteristics. CT enhanced scanning is good for displaying poorly developed small kidneys, cystic wall and separation and other parenchyma parts. The disease can be basically diagnosed.
【关键词】多囊性肾发育不良;CT;影像 学;囊腔;间隔
【中图分类号】R322.6+1
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.09.031
前言
多囊性肾发育不良(multicystic dysplastic kidney,MCDK)为非 遗传性肾发育异常所引起的发育畸形,病因主要为胚胎发育期肾与输 尿管芽融合不良[1],临床根据其形态特点将其划分为PotterⅡ型。有 文献报道[2],该病属于罕见疾病,其中单侧发病率约为0.025%,且男 性发病率为女性的2倍以上。女性则多以双侧病变为主,发病率为男 性的2倍,且往往左肾受累更明显。大量临床研究显示[3-4],双侧病变 患者往往出现明显肾功能不全,因而临床诊断较容易。而单侧病变患 者,由于健侧可代偿,因而临床表现不明显,早期诊断有一定难度。 此外,目前我国有关MCDK的研究多为产前胎儿超声检查结果,其影像 学表现易与其他肾脏多囊性疾病混淆[5]。基于此,本研究以我省2010 年1月至2016年7月收治的经临床及影像学证实的MCDK患儿16例作为研 究对象展开回顾性分析,总结儿童多囊性肾发育不良的影像学表现及 CT诊断价值,现报道如下。
中国CT和MRI杂志
第15卷, 第 9 期
2017年09月
相关文章