髓质海绵肾的X线和CT诊断

X-ray and CT diagnosis of medullary sponge kidney

目的探讨x线和CT检查对髓质海绵肾的诊断价值。方法收集从2000—2010年在我院诊治的9例髓质海绵肾病例，9例均行x线平片检查，6例静脉尿路造影检查，7例行cT平扫及增强检查，所有病例资料齐全，其中2例经手术证实。对9例髓质海绵肾的影像学表现进行回顾性分析，讨论诊断和鉴别诊断要点。结果x线尿路平片肾髓质区散发或簇状排列结石影像。6例静脉尿路造影病例，5例成功诊断，1例失败，造影显示肾集合管呈条纹状或囊状扩张，结石在收集管内。CT平扫显示环肾小盏扇形分布结石影，髓质密度减低并可见多发囊状或柱状低密度影。增强表现为。肾多发囊状影，囊内充填造影剂，可见造影剂尿液分层征象；或表现为扩张之集合管内充填造影剂。结论x线和cT检查都能准确诊断髓质海绵肾，如果X线检查失败，cT检查能补充，cT增强延迟扫描见造影剂尿液分层征象比较独特。

Objeetive To explore the values of X-ray and CT in the diagnosis of medullary sponge kidney （ MSK ）. Methods 9 patients with MSK in our hospital from 2000 to 2010 were included in this study. All the patients received plain film radiography; 6 of whom receiwd intravenous pyrography （ IVP ） anti 7 received plain and enhanced CT scans. The appearances of MSK on X-ray and CT were analyzed retrospectively. Results High-density multiple calculus were found on the plain fihns. IVP was successful an 5 of 6 patients to find dilated collecting ducts as linear or cystiform, filled with contrast medium, the calculus located ate the renal medullary. Multiple calculus at the renal medullary on CT plain scans in 7 patients, showing dilated collecting ducts as cystiform or linear, the calculus located at the dilated cysts and collecting ducts. After enhancement, the renal collecting ducts dilated as linear or cystiform and filled with contrast medium, and the contrast medium did not exclude on the delayed scans, revealing a of symbol of contrasturine division. Conlusions Both X-ray and CT scans can accurately detect medullary sponge kidney. But CT is a necessary choice as x-ray failed to make diagnosis. Contrasturine division on CT delayed scans is a special sign for diagnosis.