Wu Zhe, Tang Yi, Jiang Guo Lu, Li Ning, Jin Zheng Yu, Sun Hao
Department of Radiology, Fushun Central Hospital, Fushun, Liaoning 113006,China.
Department of Radiology, PUMC Hospital, CAMS and PUMC, Beijing 100730,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020 Dec 30;42(6):711-716. doi: 10.3881/j.issn.1000-503X.12587.
Objective To investigate the computed tomography(CT)imaging features of IgG4-related kidney disease(IgG4-RKD).Methods The clinicopathological and imaging data of 36 IgG4-RKD patients(including 26 cases of renal parenchyma,10 cases of renal pelvis,24 cases of double kidney or multiple lesions,and 12 cases of single focus)were retrospectively analyzed.Results IgG4-RKD had specific clinicopathological and imaging features.Although the kidney or renal pelvis was involved,there were no common clinical manifestations of malignant tumors such as hydronephrosis and hematuria.The boundary was clear and complete,and it had typical characteristics of continuous progressive enhancement.The peak value was mostly in the solid and excretory phase,and there were no imaging manifestations such as liquefaction,necrosis,cystic degeneration,and calcification.Even if the renal pelvis was obviously involved and the focus was large,there was no invasion of the peripheral renal parenchyma,the shape of the renal pelvis still existed,the wall was smooth,and there was no enlarged peripheral lymph nodes.Conclusions CT images of IgG4-RKD are similar to those of renal malignant tumors.Based on clinicopathological features,CT findings,and blood IgG4-related tests,a definite diagnosis can be made and unnecessary operation can be avoided.
目的 探讨IgG4相关性肾病(IgG4-RKD)的计算机断层扫描(CT)影像特征。方法 回顾性分析36例IgG4-RKD患者的临床病理及影像资料(包括肾实质26例、肾盂10例、双肾或多发病变24例、单发病灶12例)。结果 IgG4-RKD具有特异性的临床病理及影像特征。虽累及肾脏或肾盂,但无肾积水、血尿等恶性肿瘤常见临床表现。边界清晰完整,具有典型的持续渐进性强化特征。峰值大多在实质期和排泄期,无液化、坏死、囊变及钙化等影像表现。即使肾盂明显受累且病灶较大,也无外周肾实质侵犯,肾盂形态依然存在,壁光滑,外周无肿大淋巴结。结论 IgG4-RKD的CT影像与肾恶性肿瘤相似。基于临床病理特征、CT表现及血液IgG4相关检查,可作出明确诊断并避免不必要的手术。