黄色肉芽肿性肾盂肾炎的放射学诊断

Radiological Diagnosis of Xanthogranulomatous Pyelonephritis

本文分析手术病理证实的17例黄色肉芽肿性肾盂肾炎,就其相对特征性的放射学表现作一讨论。结果认为,腹部平片及静脉肾盂造影对本病无特征性表现;CT扫描对诊断本病有较大帮助,尤其是肾筋膜增厚及腰大肌肿胀有一定的特征性。根据CT征象,将其分为四型:(1)局限型;(2)弥漫型;(3)肾积水型;(4)肾周脓肿型。这种分型更能反映其病理变化在影像学上的特征,有利于对本病的诊断和鉴别诊断。

seventeen cases of xanthogranulomatous pyelonephritis (XGNP) proved by operation and pathology were collected. The purpose is to discuss that what are the relatively specific findings in XGPN. Our results suggest that there is less specific appearance of XGPN in the radiographs of the abdomen and IVP. But CT scan have greatly helpful findings in the diagnosis of XGPN, especilly the findings of thickening of Gerota's fascia and psoasmuscle. In our study,according to the appearances of CT scans XGPN may be divided into four types:(1)localized type, (2)diffuse type, 3)hydronephrosis type (4)perirenal abscess type. We belived that this CT classitication can better reflect the pathologic characteris-tics of XGPN in the imaging and is more favourable for diagnosis and differential diagnosis of XGPN.