Yamaguchi S, Fujii H, Kaneko S, Yachiku S, Anzai T, Inada F, Kobayashi T, Furuta K, Ishida H
Department of Urology, Asahikawa Medical College.
Nihon Hinyokika Gakkai Zasshi. 1990 Aug;81(8):1183-9. doi: 10.5980/jpnjurol1989.81.1183.
Ultrasonic examination of the kidney was performed on 280 patients undergoing chronic dialysis. Acquired cystic disease of the kidney (ACDK) was detected in 107 of 529 kidneys (20.2%). This paper presents an analysis of ultrasonotomograms of ACDK. Ultrasonic measurement of the size of ACDK was 72.5 +/- 15.2 mm in length and 41.7 +/- 9.8 mm in thickness. The size of ACDK was significantly greater than that of contracted kidneys by ultrasonographic diagnosis. With regard to sex distinction the length and thickness of ACDK were significantly greater in males than in females. As for laboratory data, patients with ACDK showed significantly higher values of red blood cell count, hematocrit and serum creatinine concentration compared with contracted kidneys. Prolongation of the dialysis peirod increased the incidence of ACDK. The size of ACDK showed a tendency to increase with duration of dialysis. However, no correlation was noted statistically between the incidence of ACDK and duration of dialysis and between the size of ACDK and duration of dialysis. There was a significantly lower incidence of ACDK in patients with diabetic nephropathy than those with chronic glomerulonephritis. A sonographic feature of ACDK is irregularity of the renal contour because of cystic transformation. Renal imaging, identification of the corticomedullary border, identification of the central echoes and increased parenchymal echogenicity were similar to other dialyzed kidneys. The main complications of ACDK are hemorrhage and tumor formation. We observed two retroperitoneal hematomas and one renal cell carcinoma developed within two years after this examination. The incidence of complications of ACDK was 5.1 per cent. We believe that patients with ACDK should be watched carefully by regular ultrasonic examination for early diagnosis and treatment of these complications.
对280例接受慢性透析的患者进行了肾脏超声检查。在529个肾脏中，有107个（20.2%）检测出获得性肾囊肿病（ACDK）。本文对ACDK的超声图像进行了分析。ACDK的超声测量大小为长72.5±15.2mm，厚41.7±9.8mm。通过超声诊断，ACDK的大小明显大于萎缩肾。在性别差异方面，ACDK的长度和厚度男性明显大于女性。关于实验室数据，与萎缩肾相比，ACDK患者的红细胞计数、血细胞比容和血清肌酐浓度值明显更高。透析时间延长会增加ACDK的发生率。ACDK的大小有随透析时间延长而增加的趋势。然而，在ACDK的发生率与透析时间之间以及ACDK的大小与透析时间之间未发现统计学相关性。糖尿病肾病患者的ACDK发生率明显低于慢性肾小球肾炎患者。ACDK的超声特征是由于囊性变导致肾轮廓不规则。肾脏成像、肾皮质髓质边界的识别、中央回声的识别以及实质回声增强与其他透析肾相似。ACDK的主要并发症是出血和肿瘤形成。在本次检查后的两年内，我们观察到两例腹膜后血肿和一例肾细胞癌。ACDK并发症的发生率为5.1%。我们认为，应通过定期超声检查对ACDK患者进行密切观察，以便早期诊断和治疗这些并发症。
