Sorino P, Giordano M, Puteo F, Palumbo F, Rossiello P, Caringella D A
Divisione di Nefrologia e dialisi pediatrica, Azienda Ospedaliera Di Venere, Giovanni XXIII, Bari.
Arch Ital Urol Androl. 1996 Dec;68(5 Suppl):117-23.
Increased renal medullary echogenicity by renal ultrasound associated with hypercalciuria and nephrocalcinosis is often present in childhood. 17 children, 9 boys and 8 girls, aged from 8 months to 10 years were classified into three groups based on ultrasound findings according to Patriquin and Robitaille: type A faint hyperechogenic rim around the sides and tip of the medullary pyramid; type B more intense echogenic rim of the pyramids; type C intense echoes throughout the pyramid. Clinic-echographic correlations showed a pattern C in 4 children with distal renal tubular acidosis and in an infant treated with furosemide; pattern B in 3 patients having different types of tubulopathy associated with hypercalciuria; pattern A in 6 children with congenital tubulopathy and in 3 children treated with vitamin D. Abdominal X-rays detected medullary calcinosis in 2 (11.7%) of total 17 patients. Ultrasonography appears to be an important tool in early diagnosis of renal medullary nephrocalcinosis.
小儿期常出现因肾超声检查显示肾髓质回声增强伴高钙尿症和肾钙质沉着症。根据Patriquin和Robitaille的超声检查结果,将17名年龄在8个月至10岁之间的儿童(9名男孩和8名女孩)分为三组:A型,髓质锥体侧面和尖端周围有微弱的高回声边缘;B型,锥体有更强的回声边缘;C型,整个锥体有强烈回声。临床与超声检查的相关性显示,4例远端肾小管酸中毒患儿和1例接受速尿治疗的婴儿表现为C型;3例患有与高钙尿症相关的不同类型肾小管病变的患者表现为B型;6例先天性肾小管病变患儿和3例接受维生素D治疗的患儿表现为A型。腹部X线检查在17例患者中的2例(11.7%)发现了髓质钙化。超声检查似乎是早期诊断肾髓质钙质沉着症的重要工具。