肾综合征出血热的腹部CT表现

CT findings of abdominal organs in hemorrhagic fever with renal syndrome

目的:总结分析肾综合征出血热的腹部CT表现。方法:回顾性分析经临床确诊并行CT检查的35例肾综合征出血热患者的腹部CT表现。结果:双肾肿大、肾实质增厚29例,无明显肿大6例,肾实质血肿1例,肾包膜下出血3例,肾髓质出血1例,肾周模糊伴不同程度渗出液27例,肾周筋膜水肿增厚28例;并发胰腺炎1例,脾大18例,胃壁水肿增厚3例,肝实质密度减低13例,胆囊壁水肿增厚10例,少量腹水22例,腹壁血肿2例,胸腰筋膜水肿增厚12例。结论:肾综合征出血热可引发腹部诸多组织、器官的病变,水肿﹑积液与出血是其主要的影像表现。CT对病变的检出及了解病变程度与演变具有重要价值。

Objectives： To discuss the CT findings of abdominal organs in hemorrhagic fever with renal syndrome （HFRS）. Methods：35 patients with clinically diagnosed HFPS had abdominal CT,and the CT findings were analyzed retro- spectively. Results：There were swelling of both kidneys and thickening of renal parenchymal （29 cases）, no significant swelling of kidney （6 cases）, renal parenchymal hematoma （1 case）,subcapsular hemorrhage of kidney （3 cases） and renal medullary hemorrhage （1 case）. There were also various degree of blurred perirenal space with exudation （27 cases）, perire- nal fascia edema and thickening （28 cases）, accompanied with pancreatitis （1 case）, splenomegaly （18 cases）, edema and thickening of gastric wall （3 cases） ,decreased of liver attenuation （13 cases） ,gallbladder wall edema （10 cases） ,ascites （22 cases）, abdominal wall hematoma （2 cases）, and thoracolumbar fascia thickening （12 cases）. Conclusions： Multiple abnor- malities of abdominal tissues and organs could be caused by HFRS, mainly manifested as edema, effusion and hemorrhage. CT is of great value in detecting the abnormalities and understanding the extent and their evolution.