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肾脓肿的影像学特征与膀胱输尿管反流的关系。

Association between the imaging characteristics of renal abscess and vesicoureteral reflux.

机构信息

Department of Radiology, Saitama Children's Medical Center, 1-2 Shintoshin Chuo-ku Saitama, Saitama, 330-8777, Japan.

Department of Infectious Diseases and Immunology, Saitama Children's Medical Center, 1-2 Shintoshin Chuo-ku Saitama, Saitama, 330-8777, Japan.

出版信息

J Infect Chemother. 2023 Oct;29(10):937-941. doi: 10.1016/j.jiac.2023.06.005. Epub 2023 Jun 8.

Abstract

INTRODUCTION

Renal abscesses are rare in pediatric populations. We aimed to highlight the differences in the computed tomography (CT) imaging characteristics of renal abscesses in patients with and without vesicoureteral reflux (VUR).

MATERIALS AND METHODS

Thirteen children with renal abscesses were included and categorized into those with and without VUR. Blood and urine culture results were recorded as positive or negative. Imaging characteristics were recorded: with/without subcapsular fluid collection, with/without upper/lower pole involvement, and with single/multiple lesions in kidneys. Fisher's exact test was used for intergroup comparisons of the rate of positive pathogens and imaging characteristics.

RESULTS

Nine patients had VUR (45.9%). Blood and urine culture were positive in two (15.4%) and seven cases (53.8%), respectively. There was no significant difference in the rate of pathogen-positive blood and urine cultures (blood culture positive/negative status with VUR vs. that without VUR = 2/7 vs. 0/4, p > 0.999, urine culture positive/negative status with VUR vs. that without VUR = 4/5 vs. 3/1, p = 0.559). The two groups differed significantly regarding subcapsular fluid collection presence (with/without subcapsular fluid collection with VUR vs. that without VUR = 9/0 vs 1/3, p = 0.014). There was no significant difference in upper/lower pole involvement (with/without involving upper/lower pole with VUR vs. that without VUR = 8/1 vs 2/2, p = 0.203). Patients with VUR were non-significantly more likely to have multiple lesions compared to those without VUR.

CONCLUSIONS

VUR was associated with subcapsular fluid collection and possibly with multiple lesions, indicating the need for prompt detection of and specific treatment for VUR in cases with these findings.

摘要

介绍

肾脓肿在儿科人群中较为罕见。我们旨在强调伴有和不伴有 肾盂输尿管反流(VUR)的患者的肾脓肿 CT 成像特征的差异。

材料和方法

纳入了 13 名肾脓肿患儿,并分为伴有和不伴有 VUR 两组。记录血和尿培养的结果为阳性或阴性。记录影像学特征:有无包膜下积液,上/下极受累情况,肾脏单发/多发病变。采用 Fisher 确切概率法对两组阳性病原体和影像学特征的发生率进行比较。

结果

9 名患儿存在 VUR(45.9%)。血和尿培养分别有 2 例(15.4%)和 7 例(53.8%)阳性。血培养阳性/阴性与 VUR 的关系(血培养阳性/阴性状态 VUR 与无 VUR 相比 2/7 与 0/4,p>0.999,尿培养阳性/阴性状态 VUR 与无 VUR 相比 4/5 与 3/1,p=0.559)和尿培养阳性/阴性与 VUR 的关系(尿培养阳性/阴性状态 VUR 与无 VUR 相比 4/5 与 3/1,p=0.559)均无统计学差异。两组包膜下积液的存在情况有显著差异(有/无包膜下积液 VUR 与无 VUR 相比 9/0 与 1/3,p=0.014)。上/下极受累情况无显著差异(上/下极受累 VUR 与无 VUR 相比 8/1 与 2/2,p=0.203)。与无 VUR 组相比,VUR 组的多个病变更有可能发生。

结论

VUR 与包膜下积液相关,可能与多个病变相关,表明在发现这些病变时需要及时检测和对 VUR 进行特异性治疗。

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