Heussel C P, Kauczor H U, Heussel G, Thelen M, Jahn B
Department of Radiology, Johannes Gutenberg University, Mainz, Germany.
Eur Radiol. 1999;9(4):616-9. doi: 10.1007/s003300050719.
Renal insufficiency or allergic reactions for X-ray contrast agents are frequent limitations in immunocompromised hosts such as neutropenic or AIDS patients. Due to a better tolerance of contrast agents in MRI, this technique is well suited for investigation of parenchymal organs. We demonstrate an allergic AIDS patient who presented with fever and flank pain. At sonography, anechoic renal lesions were supposed to be non-complicated cysts; however, on T2-weighted MRI, the center was of high signal. Dynamic contrast-enhanced MRI of the kidneys demonstrated an enhancing rim with ill-defined margins. The lesions were supposed to be multiple bilateral abscesses. Due to the multiple dynamic contrast series, a delayed enhancement of renal parenchyma was detectable adjacent to the lesion. This was suggested as accompanying local pyelonephritis and an infectious etiology became more reliable. Aspergillus fumigatus was identified by CT-guided biopsy as the underlying microorganism. The MR appearance of this manifestation has not been described previously.
肾功能不全或对X线造影剂的过敏反应是免疫功能低下宿主（如中性粒细胞减少或艾滋病患者）常见的限制因素。由于MRI对造影剂的耐受性更好，该技术非常适合用于实质性器官的检查。我们展示了一名出现发热和侧腹痛的艾滋病过敏患者。超声检查时，无回声肾病变被认为是无并发症的囊肿；然而，在T2加权MRI上，病变中心呈高信号。肾脏动态对比增强MRI显示边缘不清的强化环。这些病变被认为是双侧多发性脓肿。由于进行了多个动态对比系列检查，在病变附近可检测到肾实质的延迟强化。这提示伴有局部肾盂肾炎，感染病因变得更可靠。通过CT引导活检确定烟曲霉为潜在微生物。这种表现的MR表现此前尚未见报道。
