急性梗阻性肾周积液的CT与MRI表现

CT and MRI Manifestations of Acute Obstructive Perirenal Effusion

目的探讨MSCT及MRI对急性梗阻性肾周积液的诊断价值。方法回顾性分析2015年1月—2016年12月39例丰县人民医院临床随访确诊为急性梗阻性肾周积液的病例资料。重点观察肾周积液的影像学特点及并进行可能的病因学判断。39例患者,男22例,女17例,年龄19~86岁,平均(60.5±2.61)岁。患者均有16排或64排螺旋CT资料,2例有同期MRI资料。结果 39例中32例为尿路结石,3例输尿管癌,2例淋巴瘤,子宫内膜癌及宫颈癌输尿管侵犯各1例。CT平扫均可见患侧肾脏增大,密度减低,肾盂输尿管扩张积水、肾周积液。26例输尿管周围亦可见液性密度影。MPR等后处理技术可更直观清晰显示梗阻部位及渗液征象。MRI显示肾周积液呈T1WI低、T2WI及抑脂序列高信号,较CT更清晰。结论 MSCT平扫及其后处理技术可对急性梗阻性肾周积液清晰显示及病因学诊断,MRI对肾周积液诊断能力优于CT,二者相结合,可更好评价肾周积液。

Objective To study the value of MSCT and MRI in diagnosis of acute obstructive Perirenal effusion.Methods 39 cases of patients with acute obstructive perirenal effusion in our hospital from January 2015 to December 2016 were selected and the imaging features of perirenal effusion was especially observed and the possible causes were determined,of 39 cases(22 males and 17 females)aged from 19 to 86,60.5±2.61 years old on average,and all patients had 16-spiral or 64-spiral CT data,and 2 cases had the MRI data at the same period.Results Of 39 cases,there were 32 cases with lithangiuria,3 cases with carcinoma of ureter and 2 cases with lymphoma,1 case with endometrial cancer and 1 case with ureteral carcinoma of cervix violation,and the CT plain scanning showed that the renal of affected limbs increased and the density decreased and the liquid density shadow could be seen in 24 cases,and the MRP could intuitively and clearly show the obstructive site and effusion sign,and the MRI showed that the perirenal effusion was low T1WI and high T2WI and fat-suppressed sequence that was clearer than CT.Conclusion MSCT plain scanning and post-processing techniques can clearly display the acute obstructive perirenal effusion and conduct the cause diagnosis,and the diagnosis ability of MRI in perirenal effusion is better than that of CT,and the combination of the two can better evaluate the perirenal effusion.