Gloor F
Radiologe. 1978 Jan;18(1):2-7.
Morphological diagnosis and differential diagnosis of pyelonephritis are discussed particularily considering macroscopic features. A special form with radiological significance is ncrotizing "emphysematous" pyelonephritis. Chronic non-obstructive pyelonephritis is rarer than formerly thought if strict morphological criteria are applied. It should be differentiated from nephropathy caused by analgetics. In analgesic nephropathy bilateral papillary necrosis is the earliest and most characteristic alteration. Differentiation between chronic pyelonephritis and analgesic nephropathy is possible in most cases but may be difficult if analgesic nephropathy is complicated by bacterial infection. A classification of "unilateral small kidney" is presented. Unilateral acquired "renal shrinkage" should be differentiated from congenital "unilateral hypoplasia". It remains to be discussed whether the so-called "Ask-Upmark-Kidney" is a malformation or the result of chronic pyelonephritis.
本文特别结合宏观特征探讨了肾盂肾炎的形态学诊断及鉴别诊断。具有放射学意义的一种特殊类型是坏死性“气肿性”肾盂肾炎。如果应用严格的形态学标准，慢性非梗阻性肾盂肾炎比以往认为的更为少见。应将其与镇痛药所致肾病相鉴别。在镇痛药肾病中，双侧乳头坏死是最早且最具特征性的改变。多数情况下可鉴别慢性肾盂肾炎与镇痛药肾病，但如果镇痛药肾病合并细菌感染则可能存在困难。本文提出了“单侧小肾”的分类。单侧后天性“肾萎缩”应与先天性“单侧肾发育不全”相鉴别。所谓的“Ask-Upmark肾”是一种畸形还是慢性肾盂肾炎的结果仍有待探讨。
