Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, South Korea.
Department of Radiology, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang, South Korea.
J Pediatr Urol. 2022 Feb;18(1):90.e1-90.e8. doi: 10.1016/j.jpurol.2021.11.002. Epub 2021 Nov 12.
This study aimed to describe the clinical and imaging findings, including ultrasonography (US) findings, and long-term follow-up results in pediatric patients with localized cystic disease of the kidney (LCDK).
Retrospective review of pediatric patients diagnosed with LCDK based on imaging findings showing multiple localized renal cysts with intervening normal renal parenchyma from January 2002 to August 2020. Clinical presentations and US features of the affected and contralateral kidneys were reviewed and compared with computed tomography or magnetic resonance imaging findings, if available.
A total of 18 patients (male:female = 11:7; median age, 8 years) were included. Initial clinical presentations were incidental findings (n = 5), abdominal pain (n = 5), or hematuria (n = 5). Of the seven patients (7/18, 39%) who showed multiple hyperechoic foci with ring-down artifacts within the cystic lesions on US, six patients showed focal calcification of the cysts on CT. Two patients (2/18, 11%) had milimetric cysts in the contralateral kidney. During follow-up (range, 2-122 months), there was an increase in lesion size, with ipsilateral renal growth in four patients (4/18, 22%). There was no renal function impairment at the initial presentation or during follow-up in all patients.
LCDK can present with milimetric calcifications (39%), contralateral milimetric renal cysts (11%), and mild size increase during renal growth (22%) in children without renal function impairment. Follow-up US is recommended without surgical intervention in these typical cases.
本研究旨在描述小儿局限性囊性肾病（LCDK）患者的临床和影像学表现，包括超声（US）表现和长期随访结果。
回顾性分析了 2002 年 1 月至 2020 年 8 月期间基于影像学表现（显示多发性局部性肾囊肿伴间质性正常肾实质）诊断为 LCDK 的小儿患者。回顾了受累和对侧肾脏的临床表现和 US 特征，并与 CT 或磁共振成像（MRI）结果进行了比较（如果有）。
共纳入 18 例患者（男：女=11：7；中位年龄 8 岁）。初始临床表现为偶然发现（n=5）、腹痛（n=5）或血尿（n=5）。在 7 例（7/18，39%）US 显示囊性病变内多个高回声焦点伴振铃伪影的患者中，6 例 CT 显示囊肿局灶性钙化。2 例（2/18，11%）对侧肾脏有毫米级囊肿。在随访期间（2-122 个月），病变大小增加，4 例（4/18，22%）同侧肾脏生长。所有患者在初始表现或随访期间均无肾功能损害。
LCDK 可表现为毫米级钙化（39%）、对侧毫米级肾囊肿（11%）和儿童肾功能正常时肾脏生长期间轻度大小增加（22%）。在这些典型病例中，建议进行随访 US，无需手术干预。
