氯胺酮相关性肝胆、泌尿系统损害的CT诊断

Ketamine-associated CT findings of damage in liver & gall and urinary system

目的探讨滥用氯胺酮所致腹部泌尿系统及肝胆系统等器官损害的CT征象及诊断价值。方法本研究经医院伦理委员会认可,回顾性分析10例有吸食氯胺酮史(1～10年)患者的腹部CT平扫、增强扫描资料,分析氯胺酮相关性腹部器官损害的CT表现。结果 10例CT表现为膀胱容积不同程度缩小,膀胱壁增厚,增厚达3～14 mm,其中5例两侧壁增厚呈束腰状。3例双侧肾盂、输尿管扩张积水,双侧输尿管管壁较均匀增厚。4例出现多灶性肾乳头坏死,其中2例双肾实质呈多灶性缺血改变。3例表现胆总管扩张,其中2例合并肝内胆管扩张。结论氯胺酮相关性腹部脏器损害中膀胱及肾实质的CT表现可能具有一定的特征,如结合临床资料及病史有利于作出诊断。

Objective To investigate the image signs of damage e in urinary system and liver ＆ gall system and diagnostic value of CT findings in abuse of ketamine. Methods With ethics committee approval, a retrospective analysis of 10 patients with a history of taking K powder （1 to l0 years） was done with abdominal CT scan and enhanced scan data to analysis the imaging findings of ketamine-related abdominal organ damage. Results CT images of the 10 patients showed different degrees of reduced bladder capacity, bladder wall thickening with thickening range of 3-14 mm. Of which the wall were thickened on both sides with the waist-shaped in 5 patients. Bilateral hydronephrosis and hydroureterosis was found in 3 cases with uniform wall thickening of both ureters. 4 cases of renal multi-lesion papillary necrosis was found, of which 2 patients showed multi-lesion ischemic changes in renal parenchyma in both kidneys. Expansion of the common bile duct appeared in 3 cases,of which 2 cases with merger intrahepatic bile duct dilation. Conclusion CT findings of ketamine associated abdominal organ injuries in the bladder and renal may have certain characteristics. It is helpful to make diagnosis with the combination of favorable clinical data and medical history.