黄色肉芽肿性肾盂肾炎的超声表现

目的分析黄色肉芽肿性肾盂肾炎的超声表现，结合其他影像学及实验室检查以明确诊断。 方法回顾性分析2013年1月至2018年1月中国医科大学附属第一医院经手术病理证实为黄色肉芽肿性肾盂肾炎的患者7例，所有患者术前均进行了超声检查，观察肾脏大小、形态、结构改变，病灶位置、回声、血流分布及输尿管、腰大肌邻近组织器官改变。 结果7例患者中弥漫型病变5例，超声表现为患侧肾形态异常，结构紊乱，其内多个大小不等的低回声，可伴结石，肾盂、输尿管扩张或肾周受累征象；局灶型病变2例，超声表现为患侧肾体积形态多正常，其内低回声或局灶实质性结节，边界不清，边缘不规则，彩色多普勒显示血管走行分布多正常。 结论超声诊断黄色肉芽肿性肾盂肾炎可清楚显示病灶位置、范围、分型以及间接征象，但缺乏特异性表现，结合其他影像学及实验室检查可进一步明确诊断。

Sonographic features of xantogranulomatous pyelonephritis

ObjectiveTo analyse the sonographic features of xantogranulomatous pyelonephritis (XGPN) to help diagnose this disease definitely by combining with other auxiliary examinations. MethodsWe retrospective analysed the clinical data of seven cases of XGPN confirmed by operative pathology at The First Affiliated Hospital of China Medical University from January 2013 to January 2018, including size, shape, internal echo, structure, and blood flow. ResultsThere were five cases of diffuse type. Ultrasound manifestations of the diseased kidney included abnormal shape and structure and multiple hypoechoic areas of varying sizes inside, accompanied by stones, pelvis, ureteral dilatation, and perirenal involvement. There were two cases of focal type. Renal volume was normal mostly. Ultrasound imaging showed hypoechoic or focal solid nodules with unclear boundaries and irregular edges. Color Doppler showed normal distribution of blood vessels. ConclusionUltrasound can clearly show the location, scope, classification, and indirect signs of XGPN, but it lacks specific manifestations. The combination of ultrasound with other auxiliary examinations can improve the preoperative diagnosis of XGPN.