肾结核的超声特征显像分析

Analysis of sonographic features and significance in renal tuberculosis

目的探讨肾结核不同病理变化的声像图特征。方法回顾分析45例肾结核患者手术前超声检查结果,与病历资料及外科手术诊断结果进行对照分析。结果本组超声显像对肾结核的诊断准确率仅为22.2%(10/45)。肾结核病声像图表现呈多样性和复杂混合性,主要的表现为轻度积水、肾脏肿大合并肾重度积水、肾囊肿样变、肾萎缩、钙化。合并患侧输尿管结核病变发生率高达91.1%。结论超声能显示肾脏内有无结核病变征象,同时可判断其累及范围及程度,但特异性不理想,结合患侧输尿管表现仍具有较重要的临床诊断价值。

Objective To analyze the sonographic features of renal tuberculosis and investigate the diagnosis value of ultrasonography.Methods Ultrasonic findings of 45 cases with renal tuberculosis confirmed by pathology and clinic were analyzed retrospectively. Results The accuracy rate of ultrasonic diagnosis was 22.2 % （10/45）. The different sonographic patterns were shown according of their different pathologic changes. The main image characteristic was light hydronephrosis severe hydronephrosis with renal enlargement, renal cyst- like change, renal atrophy and calcification. Forty- one cases（91.1% ）were complicated with a typical ipsilateral ureteral tuberculosis. Omclusion Ultrasonography can image the tuberculous lesions and detect the area and extent of the lesions. Although the specificity is not satisfactory, Ultrasonography still has an important value in clinical diagnosis when combined with ipsilateral ureteral sonographic features.