肾结核的CT诊断与误诊分析

目的 探讨CT诊断肾结核的临床效果,并对引起CT误诊的相关因素进行分析.方法 选取经病理组织学证实为肾结核的32例患者分别行B超及CT检查,并与病理组织学结果进行对比.结果 经病理组织学证实Ⅰ型肾结核 7例,Ⅱ型肾结核 8例,Ⅲ型肾结核 6例,Ⅳ型肾结核 6例,Ⅴ型 5例.CT诊断中Ⅰ型肾结核7例,Ⅱ型肾结核 6例,Ⅲ型肾结核 6例,Ⅳ型肾结核 6例,Ⅴ型7例,符合率为93.75%（30例）.B超诊断证实Ⅰ型肾结核6例,Ⅱ型肾结核 8例,Ⅲ型肾结核 7例,Ⅳ型肾结核 7例,Ⅴ型 4例,符合率为81.25%（26例）.与B超诊断相比,CT诊断符合率较高,差异有统计学意义（P〈0.05）.CT诊断中有2例（6.25%）患者出现误诊,1例将其诊断为肾囊肿,1例为假性动脉瘤合并脓肿误诊为结核.结论 对肾结核患者应用CT诊断具有较高的诊断价值,可作为临床诊断肾结核的重要手段.

The misdiagnosis analysis of CT diagnosis of renal tuberculosis

Objective To investigate the clinical effect of CT diagnosis of renal tuberculosis and CT misdiagnosis related factors.Methods 32 patients of histologically confirmed renal tuberculosis were checked out with ultrasound and CT diagnosis and the histological results were compared.Results The histological results confirmed 7 cases of type Ⅰ,8 cases of type Ⅱ,6 cases of type Ⅲ,6 cases of type Ⅳ,5 cases of type Ⅴ.CT diagnosis confirmed renal tuberculosis 7 cases of type Ⅰ,6 cases of type Ⅱ,6 cases of type Ⅲ,6 cases of type Ⅳ,7 cases of type Ⅴ,the coincidence rate was 93.75%（30 cases）.Ultrasound diagnosis confirmed renal tuberculosis 6 cases of type Ⅰ,8 cases of type Ⅱ,7 cases of type Ⅲ,7 cases of type Ⅳ,4 cases of type Ⅴ,the coincidence rate was 81.25%（26 cases）.Compared with ultrasound diagnosis,CT diagnosis coincidence rate was higher,the difference was statistically significant（P0.05）.CT diagnosis in two cases（6.25%） patients misdiagnosed,one case be diagnosed as renal cysts,one case of pseudoaneurysm combined abscess misdiagnosed as tuberculosis.Conclusion CT diagnosis in patients with renal tuberculosis has high diagnostic value and can be an important means to diagnose renal tuberculosis.