Department of Pediatrics, Kanazawa Medical Center, National Hospital Organization, 1-1 Shimo-Ishibiki, Kanazawa, Ishikawa 920-8650, Japan.
Pediatr Nephrol. 2011 Aug;26(8):1321-4. doi: 10.1007/s00467-011-1869-y. Epub 2011 May 20.
Acute renal failure with severe loin pain induced by anaerobic exercise (ALPE) is a rare condition that is accompanied by wedge-shaped contrast enhancement on computed tomography (CT) without evidence of rhabdomyolysis. In two pediatric cases with ALPE, we tried to determine the relationship between findings from CT and magnetic resonance imaging (MRI). Case 1 involved a 13-year-old Japanese girl with a diagnosis of ALPE with normo-uricemia. Contrast-enhanced CT after 24 and 48 h showed a wedge-shaped excretion delay for the contrast media. A clear wedge-shaped signal hyperintensity matching the CT images was obtained by diffusion-weighted MRI. Case 2 involved a 16-year-old boy who presented with a second attack of ALPE after diagnosis of ALPE with hypouricemia 1 year earlier. Only diffusion-weighted imaging was performed. Clear wedge-shaped signal hyperintensity was apparent, similar to Case 1. MRI is safer than contrast-enhanced CT for patients with ALPE. Diffusion-weighted MRI is a very useful examination for diagnosing ALPE, providing noninvasive detection of lesions peculiar to ALPE.
由无氧运动（ALPE）引起的急性肾衰竭伴严重腰痛是一种罕见的病症，其 CT 表现为楔形对比增强，而无横纹肌溶解的证据。在两例儿科 ALPE 病例中，我们试图确定 CT 和磁共振成像（MRI）结果之间的关系。病例 1 涉及一名 13 岁的日本女孩，诊断为 ALPE 伴正常尿酸血症。24 小时和 48 小时后的增强 CT 显示对比剂排泄延迟呈楔形。通过弥散加权 MRI 获得了与 CT 图像相匹配的清晰楔形信号高信号。病例 2 涉及一名 16 岁男孩，1 年前诊断为低尿酸血症性 ALPE 后再次发作 ALPE。仅进行了弥散加权成像。与病例 1 一样，明显出现清晰的楔形信号高信号。对于 ALPE 患者，MRI 比增强 CT 更安全。弥散加权 MRI 是诊断 ALPE 的一种非常有用的检查方法，可以非侵入性地检测到 ALPE 特有的病变。
