Mthalane Ntombizakhona B A, Dlamini Nondumiso N M
Department of Radiology, College of Health Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa.
SA J Radiol. 2018 Feb 16;22(1):1283. doi: 10.4102/sajr.v22i1.1283. eCollection 2018.
Tuberculosis (TB) is a worldwide infectious disease burden, especially in non-developed countries, with increased morbidity and mortality among human immunodeficiency virus (HIV)-infected patients. Extrapulmonary TB is rare and renal TB is one of the commonest manifestations. The end result of renal TB is end-stage renal disease; however, this can be avoided if the diagnosis is made early. The diagnosis of renal TB is challenging because of the non-specific presentation and low sensitivity of clinical tests. Although the sequel of TB infection in the kidney causes varying manifestations depending on the stage of the disease, multidetector computed tomography (MDCT) is capable of demonstrating early findings. We performed a 20-year scoping review of MDCT findings in renal TB to promote awareness.
To identify specific MDCT imaging characteristics of renal TB, promote early diagnosis and increase awareness of the typical imaging features.
We searched published and unpublished literature from 1997 to 2017 using a combination of search terms on electronic databases. We followed the Joanna Briggs Institute guidelines.
A total of 150 articles were identified, of which 145 were found through electronic search engines and 5 were obtained from grey literature. Seventy-nine articles that fulfilled our inclusion criteria were reviewed. These included original research, case reports, literature review, organisational reports and grey literature.
Multidetector computed tomography can reproduce images comparable with intravenous excretory urography; together with advantages of being able to better assess the renal parenchyma and surrounding spaces, it is important in suggesting the diagnosis of renal TB and clinicians should consider including MDCT when investigating patients with recurrent urinary tract infection not responding to usual antimicrobial therapy.
结核病是一种全球性的传染病负担，在非发达国家尤为严重，人类免疫缺陷病毒（HIV）感染患者的发病率和死亡率不断上升。肺外结核较为罕见，肾结核是最常见的表现之一。肾结核的最终结果是终末期肾病；然而，如果能早期诊断，这种情况是可以避免的。由于临床表现不具特异性且临床试验敏感性较低，肾结核的诊断具有挑战性。尽管肾脏结核感染的后遗症因疾病阶段不同而表现各异，但多排螺旋计算机断层扫描（MDCT）能够显示早期病变。我们对肾结核的MDCT表现进行了为期20年的范围综述，以提高认识。
确定肾结核的特定MDCT成像特征，促进早期诊断，并提高对典型成像特征的认识。
我们使用电子数据库上的搜索词组合，检索了1997年至2017年发表和未发表的文献。我们遵循乔安娜·布里格斯研究所的指南。
共识别出150篇文章，其中145篇通过电子搜索引擎找到，5篇来自灰色文献。对79篇符合纳入标准的文章进行了综述。这些文章包括原创研究、病例报告、文献综述、组织报告和灰色文献。
多排螺旋计算机断层扫描能够生成与静脉肾盂造影相当的图像；加上能够更好地评估肾实质和周围间隙的优势，它对提示肾结核的诊断很重要，临床医生在调查对常规抗菌治疗无反应的复发性尿路感染患者时应考虑使用MDCT。
