Subramanyam B R, Raghavendra B N, Bosniak M A, Lefleur R S, Rosen R J, Horii S C
AJR Am J Roentgenol. 1983 May;140(5):991-3. doi: 10.2214/ajr.140.5.991.
Sonograms of 73 patients with 92 hydronephrotic kidneys were prospectively reviewed in an attempt to differentiate hydronephrosis from pyonephrosis. Sonographic diagnosis of pyonephrosis was based on the presence of persistent internal echoes, dispersed or dependent, within the dilated pelvocaliceal system. In group 1, consisting of 38 patients without clinical evidence of renal infection, sonography revealed the collecting system distended by urine to be anechoic, for a specificity of 100%. In group 2, consisting of 34 patients with clinical suspicion of renal infection, sonography showed internal echoes within the fluid-filled collecting system in 10 cases; nine of these had pyonephrosis (sensitivity of 90%), and one had hemorrhagic debris without infection (false-positive rate 3%). In the other 24 patients, sonography correctly predicted the absence of infection in all but one case (specificity 97%, false-negative rate 10%). It is concluded that in patients with clinical suspicion of renal infection, sonography has a high degree of accuracy (96%) in the differentiation of pyonephrosis from hydronephrosis.
前瞻性地回顾了73例患者92个肾积水肾脏的超声图像，以试图区分肾积水和脓肾。脓肾的超声诊断基于在扩张的肾盂肾盏系统内存在持续的内部回声，这些回声分散或呈下垂状。在第1组中，38例患者无肾脏感染的临床证据，超声检查显示尿液扩张的集合系统无回声，特异性为100%。在第2组中，34例临床怀疑有肾脏感染的患者，超声检查显示10例充满液体的集合系统内有内部回声；其中9例为脓肾（敏感性90%），1例有出血性碎屑但无感染（假阳性率3%）。在其他24例患者中，超声检查除1例误诊外，正确预测了其余所有患者无感染（特异性97%，假阴性率10%）。结论是，对于临床怀疑有肾脏感染的患者，超声检查在区分脓肾和肾积水方面具有高度准确性（96%）。
