成人胸腔肾的X线及CT诊断

X-ray,CT diagnosis of intrathoracic kidney in adult

目的总结成人胸腔肾的X线和CT表现特点及探讨其发生机制。方法分析6例经CT诊断胸腔肾患者的影像资料并结合相关文献进行回顾。结果 6例胸腔肾均位于左侧,胸部X线平片显示左下胸心影后类圆形团片阴影、左膈局限性膨出或左膈影抬高。5例胸腔肾合并Bochdalek疝,CT表现为左膈肌后侧中断缺损,缺损缘变薄,左肾上极部分疝入胸腔,其中1例合并腹主动脉后左肾静脉变异;1例胸腔肾为外伤导致,CT表现为左侧膈肌后侧破裂缺损,其断端增厚,左肾和脾脏完全疝入胸腔内。6例胸腔肾均无肾盂及输尿管积水表现。结论胸腔肾在临床较为少见,CT能够准确显示膈肌缺损位置及肾脏疝入胸腔的情况,根据CT征象判断胸腔肾的类型及其发生机制,可指导临床治疗及随访。

Objective To summarize X-ray and CT findings of intrathoracic kidney in adult and to explore the mechanism of them.Methods We retrospectively analyzed image data of 6patients who were diagnosed of intrathoracic kidney with CT and reviewed the related literature.Results 6cases of intrathoracic kidney were in the left side.Chest radiography showed a round mass in the lower field of the left thorax,diaphragmatic eventration or raised diaphragm.In these patients,the CT findings for 5cases with Bochdalek hernia included posterior diaphragmatic discontinuity or defect,defect edge thinning and herniation of the upper pole of the left kidney in the thorax.Another patient with intrathoracic kidney was caused by trauma and CT findings included posterior diaphragmatic rupture,defect edge thickening and herniation of the whole left kidney and spleen in the thorax.Hydronephrosis and hydroureter were not found in 6patients.ConclusionIntrathoracic kidney is rarely seen in clinic.CT scan can accurately show the location of diaphragmatic defect and the herniation of the kidney in the thorax.According to the CT manifestations,we can judge the types and mechanism of the intrathoracic kidney,thus guiding the clinical treatment and follow-up.