成人型多囊肾及并发症的MSCT诊断及优势

Multiple spiral CT diagnosis and the advantages of ADPKD complications

目的探讨MSCT诊断ADPKD并发症的优势及临床应用价值。方法回顾性分析18例多囊肾患者的CT表现,观察多囊肾肾实质、周围脏器及肾周筋膜的变化,确定有无并发症及病变范围。结果 18例患者中,无任何症状1例,高血压症状并肝脏多发囊肿,表现双肾及肝脏多发大小不等囊肿,或并出血、结石、钙化者共8例,其中1例脾脏见一小囊肿;腹部包块、疼痛及尿路感染症状者9例,双肾体积明显增大,轮廓呈球形突出,但仍有肾形,显示肾实质明显受压,肾盂肾盏变形,并见弧形和不规则型高密度影,肾筋膜增厚,肾周脂肪间隙模糊,呈不均匀密度增高影。结论多螺旋CT能清楚显示肾周脂肪和筋膜,是病灶检出和定位的有效方法。对临床早期发现病变、制定治疗方案、预防并发症及预后的判断具有重要的价值。

Objective Clinical application of spiral CT in the diagnosis of the complications of ADPKD advantage value.Methods A retrospective analysis of 18 cases of polycystic kidney in CT,observe the change of polycystic kidney renal parenchyma,the surrounding organs and perirenal fascia,determine whether the complications and the extent of the lesion.Results Among the 18 patients,1 case without any symptoms,hypertension and multiple liver cysts,renal and liver showed multiple ranging from the size of cyst,or bleeding,calculus,calcification were found in 8 cases,one case of splenic see a small cyst; abdominal mass,pain and urinary tract infection 9 cases,double kidney volume increased significantly,the contour is spherical outstanding,but there are still reniform,display renal parenchyma was pressed,renal pelvis deformation,and the arc and irregular high density shadow,renal fascia thickening,perirenal fatty space fuzzy,inhomogeneous density shadow.Conclusion to see in this group of 18 patients,ADPKD secondary infection accounted for about 50％,renal abscess clinical extremely difficult to diagnosis,the mortality rate as high as 60％,multiple spiral CT can clearly show the perirenal fat and fascia,so it is an effective method for detection and localization of the lesions.Has the important value of lesion,treatment,prevention of complications and prognosis of early clinical findings,uneven high density shadows.8 cases are concurrent with liver multiple cysts.Conclusion From these 18 patients in the group we can see that 50％ are adult type polycystic kidney diseases secondary with infections,mortality rates can reach up to 60％.Spiral CT can clearly show fat around the renal and fascia,thus it is an effective method to detect and localize lesions It has important values for clinical early detecting lesions,establishing treatment scheme,preventing complications and judging prognosis.