Klein U, Eisenberger F, Heinze H G, Lissner J, Pfeifer K J, Runte R, Thym W
Radiologe. 1976 Jun;16(6):240-7.
119 kidneys demonstrating changes consistent with renal tuberculosis were studied in a total of 94 patients by means of selective, transfemoral renal antiography. In the first stage of the disease, this method detected parenchymal involvement which could not be visualized by excretory urography. In stage II the arcuate arteries and occasionally the intralobular arteries, showed typical changes. Cavitation, pathognomonic for the presence of renal tuberculosis were found in 39.3% of these cases. In 40% of the cases the angiographic findingd were more extensive than the apparent findings of excretory urography. Angiography, thus, can render valuable information pertaining to the course of the disease and the necessity of operative intervention. Stage III was usually characterized by extensive changes specific for parenchymal destruction. Typical vascular lesions were readily recognized. Cavitation was found in 86.5% of these cases. Tortuosity and dilatation of the renal pelvis- and/or ureter-arteries revealed evidence of ureteral involvement (stage III2). In the presence of a non-functioning kidney angiography is mandatory to rule out renal aplasia and to differentiate between a kidney destroyed by other disease processes and the complete cavitary destruction of end-stage renal tuberculosis (stage III3).
通过选择性经股肾血管造影术，对94例患者共119个表现出符合肾结核改变的肾脏进行了研究。在疾病的第一阶段，该方法检测到排泄性尿路造影无法显示的实质受累情况。在第二阶段，弓形动脉以及偶尔的小叶内动脉出现典型改变。在这些病例中，39.3%发现了肾结核特有的空洞形成。40%的病例中血管造影结果比排泄性尿路造影的明显结果范围更广。因此，血管造影能够提供有关疾病进程以及手术干预必要性的有价值信息。第三阶段通常以实质破坏的广泛特异性改变为特征。典型的血管病变易于识别。这些病例中86.5%发现有空洞形成。肾盂和/或输尿管动脉的迂曲和扩张显示输尿管受累的证据（第三阶段2）。在存在无功能肾的情况下，必须进行血管造影以排除肾发育不全，并区分被其他疾病过程破坏的肾脏和终末期肾结核的完全空洞性破坏（第三阶段3）。
