首都医科大学学报 ›› 2016, Vol. 37 ›› Issue (4): 477-480.doi: 10.3969/j.issn.1006-7795.2016.04.012

• 感染与炎性反应放射学 • 上一篇    下一篇

HRCT检查在泌尿系结核影像诊断与指导治疗中的应用价值

王东1, 陆普选2, 袁虹3, 邓群益4, 李晶晶2   

  1. 1. 河南大学附属南阳南石医院放射科, 河南南阳 473000;
    2. 深圳市笫三人民医院放射科, 广东深圳 518112;
    3. 深圳市笫三人民医院内科, 广东深圳 518112;
    4. 深圳市笫三人民医院结核科, 广东深圳 518112
  • 收稿日期:2016-06-03 出版日期:2016-08-21 发布日期:2016-07-18
  • 通讯作者: 陆普选 E-mail:Lupuxuan@126.com

Application value of HRCT in diagnostic imaging and therapy guidance of urinary tuberculosis

Wang Dong1, Lu Puxuan2, Yuan Hong3, Deng Qunyi4, Li Jingjing2   

  1. 1. Department of Radiology, Henan University Affiliated Hospital of Nanyang Nanshi Hospital, Nanyang 473000, Henan Province, China;
    2. Department of Radiology, the Third People Hospital of Shenzhen, Shenzhen 518112, Guangdong Province, China;
    3. Department of Medicine, the Third People Hospital of Shenzhen, Shenzhen 518112, Guangdong Province, China;
    4. Department of Tuberculosis, the Third People Hospital of Shenzhen, Shenzhen 518112, Guangdong Province, China
  • Received:2016-06-03 Online:2016-08-21 Published:2016-07-18

摘要: 目的 探讨36例泌尿系结核高分辨率计算机体层摄影术(high resolution computed tomography,HRCT)表现特点以及影像学在指导治疗中的价值,以期提高诊断符合率和为规范治疗提供依据。方法 回顾性分析36例经病理及临床证实的泌尿系结核患者的病例资料,研究HRCT在泌尿系结核中的扫描技术、CT平扫及增强的影像学表现特点。同时评价HRCT在泌尿系结核治疗方案选择中的作用。 结果 1)36例泌尿系结核患者的HRCT平扫与增强中发现3例早期肾结核,表现为肾实质内小低密度病灶。2)肾内多发花瓣状低密度区25例,肾弥漫性钙化即肾自截2 例,肾皮质局限萎缩变薄 4例,肾萎缩 10例,肾盂或肾盏壁普遍增厚 4 例。3例腹膜后可见多发性大小不一的淋巴结。3)HRCT平扫加增强,对病灶侵犯脏器和周围组织的范围和程度及肿大淋巴结等进行评价,据此决定手术方式和手术时间。结论 肾实质内较小的低密度病灶,肾内多发花瓣状低密度区增强扫描后病变区瓣壁呈环状中度延迟强化,并有不规则钙化是肾结核的影像学特点。依据HRCT影像表现特点可为临床治疗方案的选择提供客观依据。

关键词: 泌尿系结核, X线计算机, HRCT表现, 诊断/治疗

Abstract: Objective To investigate the 36 cases of urinary tuberculosis on high resolution computed tomography (HRCT) appearances and the value of imaging in guiding therapy, and to improve the diagnostic consistency rate and provide the basis for standard treatment. Methods A retrospective analysis of 36 cases of urinary tuberculosis cases confirmed by pathology and clinical data, to study HRCT scanning technique of urinary tuberculosis, imaging findings of CT plain and enhanced scan and to evaluate HRCT in the role of urinary tuberculosis treatment options.Results (1) Of 36 cases of urinary tuberculosis HRCT scan and enhancement were found in 3 patients with early renal tuberculosis, characterized by small low density lesions in the renal parenchyma. (2) In the renal multiple petal shaped low-density area in 25 cases, renal diffuse calcification that since the cut in 2 cases, renal cortical atrophy thinning in 4 cases, 10 cases of renal atrophy, renal pelvis or light wall thickening in 4 cases; Three cases of retroperitoneal lymph nodes of visible multiple sizes. (3) The HRCT scan and enhancement, infringement on the scope and degree of viscera and the surrounding tissue to evaluate and swollen lymph nodes, according to this decision on operation mode and operation time. Conclusion renal parenchyma in smaller low-density lesions, within multiple petal shaped low-density lesions after enhancement scanning area disc wall showed cricoid moderately delayed reinforcement, and irregular calcification is the imaging characteristics of renal tuberculosis. Based on HRCT imaging performance characteristics can provide objective basis for the choice of clinical treatment.

Key words: urinary tuberculosis, X-ray computer, high resolution computed tomography findings, diagnosis/treatment

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