Trapani A R, Tamburri L, Di Giandomenico V, De Pascale A, Bonomo L
Istituto di Scienze Radiologiche e Formazione dell'Immagine, Università, Chieti.
Radiol Med. 1992 Jun;83(6):777-82.
The differential diagnosis of peripelvic cysts and hydronephrosis by means of US sometimes presents some problems; in fact, the use of urography to solve a diagnostic doubt is not uncommon. This study was aimed at demonstrating that another US sign, which we have called the "convexity" sign, can be useful in allowing peripelvic cysts to be distinguished from hydronephrosis. Thus, cysts exhibit convex walls and curved outline, whereas in hydronephrosis the walls of the dilated calices are linear. The latter feature is present in all degrees of hydronephrosis, except in severe cases. Forty-nine adult patients, a total of 98 kidneys, were examined with US and urography; 69 kidneys were found to be pathologic: 48 presented with cysts, and 21 with hydronephrosis. In addition to the new sign, the classic signs of peripelvic cysts were also considered, that is the separate areas and the non-visualization of the ureter. The sensitivity of the new sign was 97% and its specificity was 95%. The sensitivity and the specificity of the classic signs were 97% and 95%, respectively for the separated areas, and 100% and 91% for the non-visualization of the ureter. The cumulative sensitivity of the 3 signs was 99%, and their specificity 96%. Our results show how the integrated analysis of the considered signs (especially those with high specificity) is useful for the differential diagnosis, and therefore to avoid the indiscriminate use of urography.
通过超声鉴别肾盂周围囊肿和肾积水有时会出现一些问题；事实上，使用尿路造影来解决诊断疑问的情况并不少见。本研究旨在证明另一种超声征象，我们称之为“凸面”征，可有助于区分肾盂周围囊肿和肾积水。因此，囊肿表现为凸壁和弯曲轮廓，而在肾积水中，扩张肾盏的壁是线性的。除严重病例外，后者特征在所有程度的肾积水中均存在。对49例成年患者共98个肾脏进行了超声和尿路造影检查；发现69个肾脏有病变：48个为囊肿，21个为肾积水。除了新征象外，还考虑了肾盂周围囊肿的经典征象，即分离区域和输尿管不显影。新征象的敏感性为97%，特异性为95%。经典征象中，分离区域的敏感性和特异性分别为97%和95%，输尿管不显影的敏感性和特异性分别为100%和91%。这三种征象的累积敏感性为99%，特异性为96%。我们的结果表明，对所考虑征象（尤其是特异性高的征象）进行综合分析有助于鉴别诊断，从而避免盲目使用尿路造影。
