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关于无功能肾血管造影术鉴别诊断的思考(作者译)

[Considerations regarding the differential diagnosis during the angiography of non-functioning kidneys (author's transl)].

作者信息

Braedel H U, Schinkler E, Polsky M S, Papandreou N

出版信息

Rofo. 1979 Jul;131(1):9-16. doi: 10.1055/s-0029-1231367.

Abstract

Utilizing selective renal arteriograms and phlebograms in 7 patients, the differential diagnostic difficulties in separating poorly vascularized tumors from inflammatory lesions are discussed. Retrograde studies either offered no help, or could technically not be accomplished; arteriography proved equivocal in most cases. However, renal phlebography was found to be quite helpful, in that a non-visualized or reduced opacification of the intrarenal venous system, along with irregular extrinsic venous impressions, spoke more for a malignant tumor. When the contrast was able to fill the veins out to the periphery, a tumor could with great certainty be ruled out. Severe inflammatory conditions, while demonstrating a generalized reduction in the opacification of the venous system, did not show the bizarre venous wall irregularities seen with tumors. Retroperitoneal fibrosis and its special diagnostic difficulties are discussed.

摘要

利用7例患者的选择性肾动脉造影和静脉造影,讨论了区分血管化不良的肿瘤与炎性病变时的鉴别诊断困难。逆行研究要么没有帮助,要么在技术上无法完成;大多数情况下,动脉造影结果不明确。然而,发现肾静脉造影非常有帮助,因为肾内静脉系统未显影或造影剂充盈减少,以及不规则的外部静脉压迹,更提示为恶性肿瘤。当造影剂能够充盈静脉直至外周时,可以非常肯定地排除肿瘤。严重的炎症状态,虽然显示静脉系统造影剂充盈普遍减少,但没有显示出肿瘤所见的奇异静脉壁不规则。讨论了腹膜后纤维化及其特殊的诊断困难。

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