急性肾脏出血的CT检查及其临床意义

The clinical significance of C Tscan in the diagnosis of acute renal hem orrhage

目的 探讨 Ｃ Ｔ 检查对急性肾脏出血诊断的价值。 方法 对４２ 例急性肾区疼痛和（ 或） 肉眼血尿的患者进行 Ｃ Ｔ 检查，并与手术病理结果和临床最后诊断进行比较分析。 结果 ４２例 Ｃ Ｔ 明确诊断４１ 例，误诊１ 例， Ｃ Ｔ 诊断正确率为９７６ ％ 。本组肾盂内血块堵塞１８ 例，其中１ 例 Ｃ Ｔ 误诊为肾盂肿瘤，后经手术证实为肾盂内陈旧性血块，肾紫癜１ 例，１６ 例经保守治疗后 Ｃ Ｔ 复查，发现肾盂癌４ 例，余１２ 例出血原因不明；肾血管平滑肌脂肪瘤破裂出血１５ 例；肾外伤出血５ 例；出血性囊肿３ 例（ 其中囊肿内癌１ 例，单发和多发性肾囊肿囊内出血各１ 例） ；肾盂动脉瘤破裂出血１ 例。 结论 在急性肾脏出血时， Ｃ Ｔ 是首选检查方法，可明确出血部位、范围及程度。对部分肾出血的原因能作出肯定诊断，为临床诊断和治疗提供依据。

Objective To evaluate the clinicalsignificance of C Tscan in the diagnosis ofacute renalhemorrhage . Mathods C Tscan was carried out for 42 patients presenting with acute flank pain and/orgross hemturia and the C T manifestations were checked with the surgico pathologic diagnosis. Results Correct diagnosis has been achieved on C Tin all the patients except one(97 .6 % ) . There were 18 cases ofintrapelvic hem ato ma ,15 ruptured renal angiomyolipom a ,5 renal trau ma ,3 bleeding cysts and 1 rupturedarterio venous fistula of the renal sinus.1 case has been misdiagnosed as pelvic tu mor on C Tand turned outto be a hem ato ma on surgery .16 cases of the 18 intrapelvic hematoma have been managed conservativelyand 4 pelvic tu mors was detected on follow up C Tstudies . In 3 cases of bleeding cysts ,1 was a tumor resi ding cyst,the other 2 were simple solitary or multiple renal cysts . Conclusions C Tis the m odality offirst choice in the diagnosis of acute renal hem orrhage . The location and quantity of bleeding could be easilydefined and so me of the underlying lesions could also be detected .