Singh Abhishek, Jai Shrikant, Ganpule Sanika, Ganpule Arvind
Department of Urology and Radiology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.
Indian J Radiol Imaging. 2016 Jul-Sep;26(3):352-355. doi: 10.4103/0971-3026.190418.
Nephron sparing surgery has seen a phenomenal rise in its application over the past few decades. The use of Surgicel and gel foam for closure of defect created after partial nephrectomy has become a routine practice at many centers. In this case report, we describe radiological artifact secondary to a surgical bolster mimicking a residual disease or an early recurrence in the kidney. This case highlights two facts; first, reapproximation of the renal tissue is best done without the use of Surgicel bolsters. Second, bolsteroma should always be kept in mind as a differential diagnosis in a case where computed tomography (CT) imaging is showing early recurrence. If the surgeon is sure about the surgical margins being negative and the CT image shows a bolsteroma, the patient should be observed and a repeat scan should be done at 3-6 months, which would show regression or disappearance of the lesion proving it to be an artifact rather than malignant lesion.
在过去几十年中，保留肾单位手术的应用显著增加。在许多中心，使用速即纱和明胶海绵来封闭部分肾切除术后形成的缺损已成为常规操作。在本病例报告中，我们描述了因手术支撑物导致的放射学伪影，其酷似肾脏残余疾病或早期复发。该病例凸显了两个事实：其一，肾组织的重新对合最好在不使用速即纱支撑物的情况下进行。其二，在计算机断层扫描（CT）成像显示早期复发的病例中，应始终将支撑物瘤作为鉴别诊断考虑在内。如果外科医生确定手术切缘阴性且CT图像显示为支撑物瘤，则应对患者进行观察，并在3至6个月后进行重复扫描，这将显示病变消退或消失，证明其为伪影而非恶性病变。
