髓质海绵肾的影像学诊断

目的　结合文献复习进一步探讨髓质海绵肾各种影像学检查方法的临床应用价值。方法　回顾分析了 11例髓质海绵肾腹部平片 ( 1例 )、静脉肾盂造影 (IVP) ( 2例 )、B超 ( 3例 )及CT( 9例 )表现。结果　X线平片 1例 1肾见肾乳头、髓质区成簇排列的圆形、椭圆形高密度影。IVP 2例 3肾显示收集管呈线状、刷子状、囊状扩张。B超 3例 5肾见肾髓质内有散在密丛状排列的强回声光点 ,后方伴有声影 ,2例 3肾集合管呈囊样扩张。CT 9例 16肾有沿肾髓质分布的海绵肾结石 ,3例 5肾增强CT扫描后见结石被造影剂覆盖 ,同时有增强的条纹状高密度影从乳头伸向髓质。结论　平片、IVP、B超、CT均可用于诊断髓质海绵肾 ,X线平片、IVP仍是首选检查方法 ,IVP对集合管的扩张显示较为特异、直观 ,B超特别是CT对海绵肾结石显示率高 ,对集合管的扩张也能做出一定评价

The Imaging Diagnosis of Medullary Sponge Kidney

Objective To explore the clinical value of imaging examinations of medullary sponge kidney with the literature reviewed.Methods The features of X-ray plain film (1 case),IVP (2 cases),B-mode US(3 cases) and CT images (9 cases) of medullary sponge kidney (MSK) in 11 cases were analysed retrospectively.Results X-ray plain film showed a cluster of round and oval high density images in renal papillae and renal medulla in one case one kidney.Collecting tubes were showed as like line,brush and sac like dilatation on IVP in 2 cases 3 kidneys.B-mode US revealed a cluster of high echo spots scattered in renal medulla in 3 cases 5 kidneys and sac like dilatation of collecting tubes in 2 cases 3 kidneys.CT images showed the stones of spongiform kidney scattered alone renal medulla in 9 cases 16 kidneys,while the stones covered by contrast media on enhanced CT images in 3 cases 5 kidneys,and enhanced stripes of high density projected from renal papillae to renal medulla.Conclusion X-ray plain film,IVP,B-made US and CT all can be used in diagnosing spongiform kidney.Plain film and IVP are yet the first selected methods and IVP is specific and direct in showing collecting tubes dilatation.B-mode US especially CT have a high showing rate of stone in spongiform kidney and can be helpful to evaluate the collecting tube dilatation.