Izbudak-Oznur Izlem, Sözen Sinan, Işik Sedat
Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey.
Turk J Pediatr. 2002 Apr-Jun;44(2):168-71.
The incidence of tuberculosis has been increasing in recent years, and its treatment has also become challenging. The diagnosis of renal tuberculosis is often difficult and delayed. Early and correct diagnosis of tuberculosis with different organ system involvement is very important and can be easier with ultrasonography, computed tomography and/or magnetic resonance imaging. Although renal tuberculosis is the result of hematogenous spread more commonly from the lungs, less than 5%, of patients with urinary tract tuberculosis have active pulmonary disease. Renal tuberculosis may show variable radiological findings depending on the stage of the infection. Although an end-stage "autonephrectomized" kidey in tuberculosis is classically defined to be small in size, enlargement may on rare occasions be observed, which is the case in our patient. This form greatly mimics diffuse xanthogronulomatous pyelonephritis. Both diseases show thickening of the perirenal fasciae and spread of inflammation into the adjacent organs. Computed tomography and magnetic resonance imaging may show some specific features to differentiate these two entities.
近年来,结核病的发病率一直在上升,其治疗也变得具有挑战性。肾结核的诊断往往困难且延迟。早期正确诊断累及不同器官系统的结核病非常重要,而超声检查、计算机断层扫描和/或磁共振成像可以使诊断更容易。虽然肾结核通常是血行播散所致,多来自肺部,但在尿路结核患者中,只有不到5%的人患有活动性肺部疾病。肾结核的影像学表现可能因感染阶段而异。虽然经典的定义是,结核病晚期“自截肾”体积较小,但在极少数情况下也可能观察到增大,我们的患者就是这种情况。这种形式与弥漫性黄色肉芽肿性肾盂肾炎极为相似。这两种疾病均表现为肾周筋膜增厚,并蔓延至邻近器官。计算机断层扫描和磁共振成像可能显示一些有助于区分这两种疾病的特征。