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1、·374·实用医学影像杂志2010年第11卷第6期JPMI，2010，Vol.11,No.6·论著·髓质海绵肾的影像学表现11112张和平，王长福，靳海英，王斌杰，朱朝阳（1.河南大学淮河医院影像科，河南大学医学影像研究所，河南开封475000；2.泌尿科）【摘要】目的分析髓质海绵肾（MSK）的影像学表现，以期提高对该病诊断的正确性。方法回顾性分析8例MSK在腹部X线平片、IVP、CT及MRI上的影像表现，并进行文献复习。结果8例中累及右肾4例，左肾2例，双侧肾2例。腹部X线平片5例见肾内多发小结石呈散在或簇状排列，3例未见异常。静脉肾盂造影6例肾功能正常，肾盏外围扩张的集合管内见造影剂充盈，
2、使肾锥体呈花蕾状或葡萄串状致密影，结石位于扩张的集合管内；2例肾盂肾盏扩张，造影剂显影延迟。CT检查可以发现腹部X线平片未能显示的细小结石，增强扫描见肾锥体呈条纹状或小囊状扩张。MRI检查见肾锥体内结石在T1WI及T2WI均呈低信号，T2WI及MRU成像肾锥体内可见条纹状、放射状及小囊状高信号影，大小不等。结论MSK有其特征性影像表现，IVP、CT、MRI都有助于MSK的诊断，但以IVP检查为首选。【关键词】髓质海绵肾；腹部平片；静脉肾盂造影；体层摄影术，X线计算机；磁共振成像【中图分类号】R445;R692.6【文献标识码】A【文章编号】1009-6817（2010）06-0374-03Im
3、agingfindingsofmedullaryspongekidneyZhangHeping,WangChangfu,JinHaiying,WangBinjie,ZhuChaoyang.DepartmentofRadiology,HuaiheHospital,HenanUniversity;TheResearchInstituteofMedicalImageinHenanUniversity,Kaifeng475000,China【Abstract】ObjectiveToanalyzetheimagingfindingsofmedullaryspongekidney(MSK),soastoi
4、mprovethediagnosticaccuracyofMSK.MethodsReferringtoliterature,imagingfindingsofplainfilm,IVP,CTandMRIof8caseswithMSKwereretrospectivelyanalized.ResultsAmong8caseswithMSK,4casesoccurredinrightkidney,2casesoccurredinleftkidneyand2casesoccurredinbilateralkid－ney.Onplainabdominalradiograph,5casesshoweds
5、catteredorclusteredmicrolithsinkidney;Noabnormalitywasseenin3cases.IVPshowednormalrenalfunctionin6cases,anddilatedcollectingductsurroundingrenalcaliceswasfilledwithcontrastmediumthatmaderenalpyramidsofferalabastrumorthyrsiformpykno-shadow,besidescalculuswasseenindilatedcollectingduct.Pyelocaliectasi
6、soccurredin2cases,anddevelopingofcontrastmediumwasdelayed.CTcouldshowmicroliththatcouldn'tbeseeninplainabdominalradiograph,andenhancedCTshowedbarredorsacculiformrenalpyramids.MRIofcalculusinrenalpyramidsshowedhypointensityonT1WIandT2WI.T2WIandMRUshowedbarred,radialandsacculiformhyperintensity.Conclu
7、sionMSKoffereditsdistinctiveimagingfindings,whileIVP,CT,MRIwereallhelpfulfordiagnosisofMSKbutIVPwasthepreferredmethod.【Keywords】Medullaryspongekidney;Abdominalradiograph,plain;Intravenouspyelogram;Tom
