多囊性发育不良肾与多囊肾的超声鉴别.docVIP

多囊性发育不良肾与多囊肾的超声鉴别 【摘要】 目的　探讨多囊性发育不良肾(MCDK)的声像特征及其与多囊肾的鉴别诊断。方法　回顾性分析35例多囊性发育不良肾的声像特征。结果　35例患肾均为单侧。患肾丧失正常的实质和肾窦结构, 代之以数目、大小不等, 互不相通杂陈之囊泡。各年龄组患肾的长径、厚径均小于对侧健肾, 除1~3岁组患、健肾的厚径外, 其余差异均具统计学意义( p0.05)。本组其它泌尿系发育异常伴发率20% 。结论　超声可从是否为单侧肾病变及患肾的大小、形态、囊泡形态和是否伴发其它泌尿系畸形等方面对MCDK与多囊肾鉴别, 可作为MCDK诊断和随访首选的影像学检查。 【关键词】 多囊性发育不良肾 超声诊断 鉴别诊断 多囊肾 The ultrasonographic differential diagnosis of multicystic dysplastic kidney and polycystic kidney WU Wei, GU Lai-Lai, ZHU Hui-Yi, JIANG hai-yan ( Department of Imagining, Shanghai Childrens Hospital of Jiao Tong University Shanghai, 200040 china) 【Abstract】 Objective To investigate the sonographic features of multicystic dysplastic kidney (MCDK) and the differentiation between MCDK and polycystic kidney. Methods Sonographic feaures of 35 cases of MCDK were retrospectively studied. Results The lesion of MCDK was unilateral and the renal parenchyma was replaced by randomly distributed cysts of variable number and size. The length and thickness of the affected kidney were significantly shorter than that of the contralateral healthy kidney in different age-graded groups ( p0.05), except the thickness in 1-3yr group. The incidence of associated urological anomalies was 20% in these cases. Conclusion Ultrasonography can differentially diagnose the MCDK from polycystic kidney based on the size, shape of the affected kidney and the cysts and whether the lesion is unilateral and associated with other urological abnormalities. Ultrasonography can be act as the first line imaging method in the diagnosis and follow up of MCDK. 【Key words】Multicystic dysplastic kidney; Ultrasonography; Diagnosis 多囊性发育不良肾(multicystic dysplastic kidney MCDK)是临床并不常见的肾脏发育异常, 然因其多囊的声像表现在超声诊断中常被误做多囊肾; 国内相关文献多为个例报告[1]且多为产前胎儿超声检查结果[2], 本文试以对本院经年累积儿童相关病例回顾分析, 探讨该病的声像特征及其与多囊肾的鉴别诊断。 1　资料与方法 1.1　对象 2001年7月-2008年10月在上海市儿童医院超声检查诊断为MCDK者35例。患儿按年龄分组: 1岁以内12例(最小为生后2天, 最大为5个月), 1~3岁11例, 5~7岁6例, 9~12岁6例。其中男20例, 女15例。 1.2　仪器 采用ATL HDI 3500型超声诊断仪, 选取频率分别为8~5MHz和5~2MHz的宽频凸阵探头。 1.3　方法 询问有无家族史及其它影像学检查情况。