儿童急性局灶性细菌性肾炎的CT诊断(附12例报告)

CT Features of Acute Focal Bacterial Nephritis in Children(Report of 12 Cases)

目的分析儿童急性局灶性细菌性肾炎(acute focal bacterial nephritis,AFBN)的多层螺旋CT(MSCT)表现特征,探讨MSCT对AFBN的诊断及鉴别诊断价值。资料与方法经临床证实的12例AFBN患儿均行CT平扫及增强扫描,并行冠状位多平面重组(MPR)、容积再现(VR)、最大密度投影(MIP)重组,观察双侧肾脏形态、密度改变以及实质的灌注情况。12例尿培养均呈阳性。结果 CT表现分两型:典型者表现为单/双侧肾脏形态增大,实质灌注减低伴多发"楔"形或片状病灶,底部朝向肾外,尖端指向肾盂;不典型者肾脏内病灶呈肿块状,多单发,不均匀强化。结论 MSCT特别是增强扫描对于诊断儿童AFBN有一定优势,有助于提高对病变的诊断准确率。

Objective To analyze MSCT characteristics of acute focal bacterial nephritis in children,and to discuss the value of MSCT in the diagnosis and differential diagnosis.Materials and Methods Twelve cases of acute focal bacterial nephritis clinically confirmed underwent routine CT and enhanced CT examination.Coronal MPR,VR,MIP images were reconstructed,The imaging findings of both kidneys including shape,density and perfusion changes were observed.The urine cultivation were positive in 12 patients.Results The CT findings were separated in two types： the typical type showed the unilateral or bilateral renal swelling,reducing perfusion with multiple wedge or slice lesions,The bottoms of the leisions faced to the kidney surface,and the tips of them pointed to the renal pelvis.Atypical type showed tumor like lesions in the kidney,usually solitary,heterogeneous enhancement.Conclusion MSCT,especially enhanced MRCT examinations,have certain advantages in the diagnosis of acute focal bacterial nephritis in children and help to improve the diagnosis accuracy.