肾盏憩室的CT诊断

CT diagnosis of calyceal diverticulum

目的探讨肾盏憩室的CT表现及诊断价值。方法对静脉尿路造影诊断的18例肾盏憩室患者行螺旋CT平扫、增强扫描及延时扫描,并对图像进行综合分析。结果CT平扫表现为肾实质内单发的圆形或类圆形囊性水样低密度灶,密度均匀,15例囊底部可见并发的结石影。增强扫描病灶密度均匀增高,CT值超过25Hu,并形成液液平面,延时扫描病灶内液面升高或病灶完全被对比剂充填,并且持续很长时间。结论CT检查能清晰地显示肾盏憩室的特征性影像学改变,准确地与其他肾脏疾病相鉴别,是诊断肾盏憩室的重要手段。增强延时扫描是诊断与鉴别诊断的关键。

Objective To study the helical CT findings of calyceal diverticulum and evaluate its diagnostic value. Methods Eighteen patients, diagnosed as calyceal diverticulum by intravenous urography （IVU）, were performed three repeated scans to the kidney area： an unenhanced scan, post-contrast scan and a delayed scan, then the imagines were analyzed. Resuits Unenhanced scans findings were intraparenchymal isolated round or round-like lesion with cystic liquid homogeneous hypodensity, and calcific material localized at the inferior border of the cavity were shown among 15 cases. On post-contrast scans, a contrast-fluid level appeared, with some degree of enhancement of the clear fluid in the upper part of the cyst, and the CT value elevated more than 25 Hu. A further rise in the contrast-fluid level or total opacification with a density identical to that of the collecting system was obtained on delayed scans, and lasted for a long time. Conclusion Three phase CT scan could clearly display the characteristic changes of calyceal diverticulum, and could correctly distinguish it from other kidney diseases. Post-contrast delayed scan is the key of diagnosis and differential diagnosis.