髓质海绵肾的X线平片、IVP和CT诊断

The X-ray film,IVP and CT Diagnosis of Medullary Sponge Kidney

目的:揭示髓质海绵肾的X线平片、静脉肾盂造影(IVP)和CT表现及其诊断价值。方法:回顾性分析14例髓质海绵肾临床影像学资料,14例均行X线平片检查,其中7例行IVP检查,4例仅行CT平扫检查,6例行CT平扫和增强扫描。结合文献复习分析其各自影像学表现和诊断价值。结果:髓质海绵肾在X线平片上表现为肾实质内肾乳头区多发斑点状钙质样致密影,呈簇状分布成扇形排列。IVP表现为集合管扩张积液,内见结石,肾功能正常。CT平扫表现为肾盏旁锥体内多发小斑点状结石,成扇形排列。增强扫描后扩张的集合管内结石周围有造影剂充盈,无结石的集合管呈条纹状或小囊状造影剂积聚,肾功能正常。结论:髓质海绵肾的X线平片、IVP和CT表现具有特征性,CT可作出明确诊断。

Objective To evaluate the imaging findings and diagnostic value of X-ray film,Intravenous pyelography （IVP） and CT in medullary sponge kidney.Methods The imaging manifestations of 14 cases were studied retrospectively and the diagnostic value of X-ray film, IVP and CT were analyzed combining with literature.14 cases were examined by X-ray film. Among 14 cases ,seven cases were examined by IVP and ten cases were examined by CT. Results X-ray plain film showed a cluster of round and oval high density images in renal papillae within kidney. IVP showed dilated collecting ducts and calculus within ducts. Unenhanced CT revealed multiple small calculus in renal pyramid.Alter enhancement,the contrast medium around the small stone were seen in dilated collecting ducts,and the pyramids without calculus presented a striped or small cyst-like collection of contrast medium. The renal function was normal. Conclusion X-ray film,IVPand CT are of diagnostic characteristics for medullary sponge kidney. CT can make definite diagnosis.