Department of Radiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
Department of Radiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
Am J Kidney Dis. 2019 Apr;73(4):552-565. doi: 10.1053/j.ajkd.2018.12.029. Epub 2019 Feb 15.
Renal imaging has become a fundamental part of clinical care for patients with kidney disease. Imaging strategies for the kidney have been evolving during the past hundred years and have been even more rapidly changing during the past couple of decades due to the development of modern computed tomographic techniques, magnetic resonance imaging, and more sophisticated ultrasonographic techniques, such as contrast-enhanced ultrasonography. Applying the correct radiologic study for the clinical situation maximizes the diagnostic accuracy of the imaging, and a judicious choice between techniques helps limit radiation dose and potential adverse events. This Core Curriculum outlines the imaging modalities currently in use in radiology departments and is divided into 3 sections: (1) a review of the development of renal imaging and an outline of modalities available to the nephrologist, (2) imaging strategies for select clinical situations, and (3) a discussion of some potential adverse events from imaging, including effects of iodinated contrast on kidney function, risks of gadolinium-based contrast agents in kidney failure, and potential risks of imaging techniques that use ionizing radiation.
肾脏影像学已成为肾脏病患者临床治疗的重要组成部分。过去一百年中,肾脏影像学策略一直在不断发展,而在过去几十年中,由于现代计算机断层扫描技术、磁共振成像以及更复杂的超声技术(如对比增强超声)的发展,其变化更为迅速。为临床情况选择正确的影像学研究可以最大限度地提高影像学的诊断准确性,在技术之间进行明智的选择有助于限制辐射剂量和潜在的不良事件。本核心课程概述了放射科目前使用的影像学方式,分为 3 个部分:(1) 回顾肾脏影像学的发展以及肾脏病医生可用的方式概述,(2) 选择临床情况的影像学策略,以及(3) 讨论一些影像学的潜在不良事件,包括碘造影剂对肾功能的影响、肾功能衰竭时钆基造影剂的风险,以及使用电离辐射的影像学技术的潜在风险。