肾综合征出血热的肾脏CT、超声改变及临床意义

张宝林; 杨军妍

中国临床医学影像杂志 ›› 2006, Vol. 17 ›› Issue (4) : 220-222.

论著

肾综合征出血热的肾脏CT、超声改变及临床意义

张宝林,杨军妍

作者信息 +

CT and ultrasonic features of kidney in hemorrhagic fever with renal syndrome

ZHANG Bao-lin, YANG Jun-yan

Author information +

文章历史 +

摘要

目的:提高对肾综合征出血热所致肾脏损害的CT、超声影像诊断水平,分析二者图像的影像特点,提出CT在诊断肾破裂出血的影像特异性,使临床医生能主动掌握病情。方法:63例临床确诊病例进行了肾脏CT、超声观察,总结出肾脏改变的5点影像征象,从不同年龄组进行统计分析。结果:肾脏改变影像特征:①双肾脏呈球形对称性增大。②肾小盏聚集,肾盂腔缩小。③肾实质密度不均匀,肾皮质呈低密度,肾髓质呈稍高密度。④肾破裂出血表现为肾实质、肾周间隙及肾包膜下的血肿,血肿形态早期呈团状及不均匀性高密度影像,以后逐渐密度下降,超声呈混合密度影像。⑤CT增强扫描肾髓质密度增高,肾小盏界限模糊。本文分析了肾脏影像改变与出血热患者在发热期、休克期、少尿期、多尿期中肾脏改变和病情的关系。结论:肾综合征出血热起病急,以发热、出血及肾脏损害为主要征象,肾脏行影像学检查尤其是疑有肾破裂出血做CT扫描,具有特异性诊断。

Abstract

Objective: In order to promote the diagnostic accuracy, CT and ultrasonic(US) features of renal damage in hemorrhagic fever with renal syndrome(HFRS) were analyzed. Materials and Methods: CT and US observation of kidney were performed in 63 hospitalized patients. The CT and US features of renal damage were analyzed according to different ages. Five imaging characteristic features of renal damage were found. Results: The characteristic features of renal damage were: ①Kidneys were symmetrically enlarged on both sides. ②Aggregation of minor calyces and shrinking of renal pelvis. ③Inhomogeneous of renal density, hypointense of renal cortex, and slightly hyperintense of renal medulla. ④Renal rupture and hemorrhage showed hematoma in perirenal and subcapsular space. In the early phase hematoma appeared inhomogeneous hyperintense and became hypointense gradually. It appeared mixed density on ultrasonography. ⑤On enhanced CT scanning the density of renal medulla increased, the margin of renal calyces became indistinct. In this study, the imaging features of kidney were analyzed according to the stages of the disease, that is the pyretogenetic stage, shock stage, oliguria stage, and diuretic stage. Conclusion: There are three principal signs such as acute onset, hemorrhage and renal damage of HFRS. CT scanning has specific value in diagnosing the disease especially when rupture of kidney and hemorrhage is suspected.

导出引用

张宝林;杨军妍. 肾综合征出血热的肾脏CT、超声改变及临床意义[J]. 中国临床医学影像杂志. 2006, 17(4): 220-222

ZHANG Bao-lin;YANG Jun-yan. CT and ultrasonic features of kidney in hemorrhagic fever with renal syndrome[J]. Journal of China Clinic Medical Imaging. 2006, 17(4): 220-222

中图分类号： R512.8 R692 R814.42 R445.1