Choyke P L, Grant E G, Hoffer F A, Tina L, Korec S
Department of Radiology, Georgetown University Hospital, Washington, D.C.
J Ultrasound Med. 1988 Aug;7(8):439-42. doi: 10.7863/jum.1988.7.8.439.
The initial renal sonograms of 15 patients, aged 8 months to 5 years, with hemolytic uremic syndrome (HUS) were reviewed. Ultrasound studies were graded according to cortical echogenicity relative to the liver, they were compared to the severity of the clinical syndrome at admission and to the ultimate outcome of the disease. The degree of cortical echogenicity correlated with the clinical outcome of HUS in 12 of the patients, whereas clinical assessment alone predicted outcome in 13 patients. Sonography overestimated severity in three patients with mild disease correctly assessed clinically, whereas clinical assessment overestimated severity in two patients with moderate disease in whom the sonographic assessment proved correct. The sonographic changes are most likely multifactorial. They appear to reflect a combination of platelet-thrombus deposition in the renal cortex, as well as the general fluid status of the patient. Ultrasound is useful in ruling out other causes of acute renal failure such as obstruction or congenital diseases. It cannot replace laboratory tests and clinical judgement, but nevertheless provides another index of severity in patients with HUS.
回顾了15例年龄在8个月至5岁之间的溶血尿毒综合征（HUS）患者的初始肾脏超声检查结果。超声检查根据相对于肝脏的皮质回声进行分级，并与入院时临床综合征的严重程度以及疾病的最终结局进行比较。12例患者的皮质回声程度与HUS的临床结局相关，而仅临床评估就能预测13例患者的结局。超声检查高估了3例临床评估为轻度疾病患者的严重程度，而临床评估高估了2例中度疾病患者的严重程度，超声评估结果证明是正确的。超声检查结果很可能是多因素导致的。它们似乎反映了肾皮质中血小板血栓沉积以及患者的总体液体状态。超声有助于排除急性肾衰竭的其他原因，如梗阻或先天性疾病。它不能取代实验室检查和临床判断，但可为HUS患者提供另一个严重程度指标。
