Doery Ashlea J, Ang Eileen, Ditchfield Michael R
Department of Diagnostic Imaging, Monash Health, Clayton, Victoria, Australia.
J Med Imaging Radiat Oncol. 2015 Apr;59(2):149-53. doi: 10.1111/1754-9485.12285. Epub 2015 Feb 23.
Duplex kidneys are common, mostly asymptomatic and of no clinical significance. However, they can be associated with significant pathology, often with long-term morbidity. There is minimal literature on the review of the duplex kidney, its associated anomalies and complications. The purpose of this paper is to review our experience of imaging the spectrum of abnormalities associated with duplex kidneys in the paediatric population and correlate this with contemporary literature.
A retrospective review of the radiology database in a tertiary paediatric centre was performed. A word search of the Radiology Information System for 'duplex' of patients under the age of 16 was undertaken and limited to studies performed between 2006 and 2013.
Two hundred seventy-four patients were identified (age range 0-16, median 3 years, gender 59.9% female) who had 836 studies: ultrasound 598/836 (71.6%), nuclear medicine 180/836 (21.5%), micturating cystourethrogram 52/836 (6.2%), MRI 5/836 (<1%) and CT scan 1/836 (<1%). Patients were categorised as duplex and no complication (151/274 = 55.1%), upper moiety obstruction, lower moiety reflux/scarring, multicystic dysplastic kidney, abnormal ureteric insertion and other pathology.
Duplex kidneys are common and often not clinically significant. However, this study demonstrates almost 50% of paediatric patients investigated for duplex kidneys had complications requiring treatment. The most common complications were upper moiety obstruction associated with a ureterocele and lower moiety vesicoureteric reflux. Ultrasound was the most common modality for early detection of these complications.
重复肾很常见，大多无症状，无临床意义。然而，它们可能与严重病变相关，常伴有长期发病情况。关于重复肾及其相关异常和并发症的综述文献极少。本文的目的是回顾我们对儿科人群中与重复肾相关的一系列异常进行成像的经验，并将其与当代文献进行关联。
对一家三级儿科中心的放射学数据库进行回顾性研究。在放射学信息系统中对16岁以下患者的“重复”进行关键词搜索，并限于2006年至2013年期间进行的研究。
共确定了274例患者（年龄范围0 - 16岁，中位数3岁，女性占59.9%），他们进行了836项检查：超声检查598/836（71.6%），核医学检查180/836（21.5%），排尿性膀胱尿道造影52/836（6.2%），MRI检查5/836（<1%），CT扫描1/836（<1%）。患者被分类为重复肾且无并发症（151/274 = 55.1%）、上半部分梗阻、下半部分反流/瘢痕形成、多囊性发育不良肾、输尿管异位开口及其他病变。
重复肾很常见，通常无临床意义。然而，本研究表明，接受重复肾检查的儿科患者中近50%有需要治疗的并发症。最常见的并发症是与输尿管囊肿相关的上半部分梗阻和下半部分膀胱输尿管反流。超声是早期发现这些并发症最常用的检查方式。
