多囊性发育不良肾的超声评价。

S. J. Han, C. Yu, G. C. Liu, W. Yao, T. Lee
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引用次数: 3

摘要

11例儿童多囊性发育不良肾(MCDK)在11年期间被诊断。所有患者均接受了产后超声(US)检查。发现四种不同的MCDK模式:(1)6例具有典型的多囊成分超声图。(2)肾积水3例;MCDK肾积水型与肾积水的正确诊断比较困难,因为它是一个位于中间的分叶状大囊肿,并且大囊肿与邻近的小囊肿有联系。(3) 1例患者最初表现为肾脏超声正常,但在随访超声检查中发现一个小囊肿,肾脏体积减小,回声增强。(4) 1例仅有2个中等大小囊肿,未见肾实质。2例随访超声检查,1例肾发育异常,超声检查显示肾大小减小。静脉尿路造影和放射性核素检查显示这两个发育不良的肾脏没有功能。9名儿童接受了病变肾脏的手术切除。对侧肾脏异常5例,包括输尿管肾盂连接处狭窄、输尿管膀胱连接处狭窄、输尿管远端狭窄和多囊肾病。三种肾积水形式的MCDK中有两种有对侧输尿管狭窄。6例典型MCDK中有2例对侧输尿管狭窄。肾积水型MCDK组对侧输尿管狭窄比例较高。超声检查有助于MCDK的明确诊断;然而,单纯性肾积水的鉴别诊断需要考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ultrasonographic evaluation of multicystic dysplastic kidney.
Eleven cases of multicystic dysplastic kidney (MCDK) in children were diagnosed over an 11 year period. All underwent postnatal ultrasound (US) studies. Four different patterns of MCDK were recognized: (1) Six cases presented with the classic sonogram of multicystic components. (2) Three cases had hydronephrotic form; correct diagnosis between hydronephrotic form of MCDK and hydronephrosis was difficult as there was a medially-located, large, lobulated cyst and there was connection between the large cyst and neighboring small cysts. (3) One case initially presented with normal renal sonogram but a small cyst appeared on follow up sonogram and there was also decreased renal size and increased echogenecity. (4) One case had only two moderate-sized cysts but no identifiable renal parenchyma. Two cases had follow-up US examination and one dysplastic kidney decreased in renal size on follow-up sonogram. Intravenous urography and radionuclide study revealed both these dysplastic kidneys to be nonfunctioning. Nine children had surgical resection of the diseased kidneys. Contralateral renal anomalies were detected in five children, which included ureteropelvic junction stenosis, ureterovesical junction stenosis, distal ureteral stenosis and polycystic kidney disease. Two of three hydronephrotic forms of MCDK had contralateral ureteral stenosis. Two of six classic forms of MCDK had contralateral ureteral stenosis. The proportion of contralateral ureteral stenosis was higher in the group of hydronephrotic forms of MCDK. Ultrasonography is beneficial for conclusive diagnosis of MCDK; however, a differential diagnosis of simple hydronephrosis needs to be considered.
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