肾脏罕见炎性肿块患者超声表现

Ultrasonographic manifestations of rare renal inflammatory mass

目的总结肾脏罕见的黄色肉芽肿性肾盂肾炎(XGP)及肾脏炎性假瘤(RIP)患者肾脏炎性肿块的超声表现。方法回顾性分析2004—2011年我院收治的4例XGP及2例RIP患者的超声声像图特征,包括肿块大小、肿块形态、边界、回声强弱及局限性回声改变、内部血流等情况。6例肾脏罕见炎性肿块患者均经术后病理证实,且1例患者合并肾早期透明细胞癌。结果 6例肾脏罕见炎性肿块超声声像图多表现为形态不规则、边界清或不清、内部以低回声为主或中等回声为主或强回声为主,肿块伴有强回声团伴声影,部分肿块内血流信号丰富,均未见肿块内液化、坏死。其中超声提示2例良性,1例恶性,2例恶性不排除,1例误诊为肾结核或肾脏畸胎瘤。结论肾脏罕见炎性肿块的超声表现有一定的特点,但并无特异性表现。超声检查可协助鉴别诊断,具有一定的临床价值。

Objective To analyze the ultrasonographic manifestations of inflammatory mass in the rare diseases of xanthogranulomatous pyelonephritis and renal inflammatory pseudotumor.Methods Four patients with asxanthogranulomatous pyelonephritis and 2 with renal inflammatory pseudotumor underwent ultrasonography in our hospital between 2004 and 2011.The clinical data and ultrasound features were retrospectively reviewed,including mass size,shape,boundary,echogenecity and internal blood supply.All the results were confirmed by pathology.Renal transparent cell carcinoma was also identified in one case by pathology.Results According to ultrasonography,the mass of xanthogranulomatous pyelonephritis and renal inflammatory pseudotumor were mostly irregular in shape,with clear or fuzzy boundaries,predominantly hypo-,equal-or hyper-echoic masses.Some mass had hyperecho clumps with acoustic shadow.Color Doppler imaging showed a hypervascularized mass.No liquid or necrosis were found in them.Two lesions were diagnosed as benign,1 was malignant,and 2 cases were uncertain.One cases was misdiagnosed as renal tuberculosis or renal teratoma.Conclusions The rare renal inflammatory mass presents some common,but not specific ultrasound features.Ultrasound is helpful for the differential diagnosis of renal inflammatory mass.