肾结核的影像学表现及临床应用价值.doc

肾结核的影像学表现及临床应用价值 　　作者：王峰， 王静， 王玉杰 作者单位：(新疆医科大学第一附属医院1泌尿外科, 2影像中心, 新疆乌鲁木齐830011) 　　【摘要】 目的：探讨B超、静脉肾盂造影与CT的肾结核表现及其对肾结核诊断的临床应用价值。 方法：54例肾结核患者行B超、静脉肾盂造影与CT检查，分别从肾脏形态改变、肾实质、肾盂肾盏、输尿管、肾功能、有无钙化等方面对肾结核做出诊断;其中21例经手术治疗的中晚期肾结核患者，分别用3种影像学方法对其显示的典型肾结核特点(包括空洞、肾盂输尿管壁增厚和不规则钙化)结果进行分析。结果：B超、静脉肾盂造影及CT诊断肾结核的准确率分别为53.3%，62.8%和90.7%。CT对中晚期肾结核空洞、肾盂输尿管壁增厚和不规则钙化的显示明显优于B超和静脉肾盂造影。结论：CT能够对肾结核病变范围、程度、定位做出正确判断，可作为肾结核治疗前进行评价并制定治疗方案的最有效的影像学检查方法。 　　【关键词】 肾结核; X线计算机体层摄影; 诊断 　　The imaging features and clinical application of ultrasounography,IVP and CT in evaluation of renal tuberculosis 　　WANG Feng， WANG Jing, WANG Yujie 　　(Department of Nephrology, First Affiliated Hospital, Xinjiang Medical University,Urumqi 830011, China) 　　Abstract: Objective: To discuss the imaging features and clinical application of ultrasounography, intravenous pyelography (IVP), and computed tomography (CT) in evaluation of renal tuberculosis (TB). Methods: The imaging data of 54 patients with renal TB confirmed by clinical and pathology were analyzed retrospectively. All cases underwent ultrasounography, IVP and CT. According to pathological characteristics of renal TB, we reviewed the corresponding imaging disorders including renal distortation, parenchyma， pelvis, urethra, renal function and calcification. 21patients with advanced renal TB accepted surgery, which imaging features were compared with pathological results. Results: The accuracy of ultrasounography, IVP and CT in diagnosis of renal TB were 53.3%, 62.8% and 90.7%, respectively. As far as displaying the cavity, thickening of pelvis and ureter, calcification of advanced renal TB, CT is more sensitively than IVP and ultrasounography. Conclusion: CT could demonstrate the range, site, extent of renal TB and it can be as a more effective method to evaluate the disease before clinical therapy. 　　Key words: renal tuberculosis; computed tomography; diagnosis 　　肾结核是肺外结核最常见的部位，占肺外结核的20%[1]。正确认识肾结核的各种影像学表现及其临床应用价值，对该病的诊断及治疗有重要作用。本文对2006年1