Glassberg K I, Kassner E G
Division of Pediatric Urology, State University of New York Health Science Center at Brooklyn, USA.
J Urol. 1998 Sep;160(3 Pt 2):1204-6; discussion 1216. doi: 10.1097/00005392-199809020-00069.
Classically cysts in multicystic dysplastic kidneys are described as noncommunicating. We determined the accuracy of this hypothesis by performing ex vivo intracystic contrast studies of the typical multicystic kidney and hydronephrotic form of the multicystic kidney.
We evaluated 7 multicystic dysplastic kidneys in patients between 2 weeks and 6 months old using intracystic injection of contrast material, including 4 that were typical and 3 with the hydronephrotic form of multicystic disease. Six and 1 kidneys were evaluated ex vivo and percutaneously, respectively. We obtained images during injection and shortly thereafter.
When contrast material was injected into 1 cyst, it was eventually seen in most of the other cysts in all 7 kidneys. In 6 kidneys discrete ducts were clearly visualized between the cysts. In the hydronephrotic form of the disease these ducts connected to a pelvis-like structure. When evaluated grossly and the cysts were unroofed, a small orifice was noted in each cyst that sometimes admitted a 3.5F feeding tube.
It is generally thought that multicystic kidneys represent a condition with noncommunicating cysts. We believe that the cysts in most multicystic kidneys communicate whether or not a renal pelvis is present.
经典描述认为多囊性发育不良肾中的囊肿是不连通的。我们通过对典型多囊肾和多囊肾积水形式进行体外囊内对比研究，确定这一假说的准确性。
我们对7例年龄在2周龄至6月龄之间的患者的多囊性发育不良肾进行评估，采用囊内注射对比剂，其中4例为典型多囊肾，3例为多囊病积水形式。分别对6例和1例肾脏进行体外和经皮评估。在注射对比剂期间及之后不久获取图像。
当向1个囊肿内注射对比剂时，最终在所有7例肾脏的大多数其他囊肿中均可见到。在6例肾脏中，囊肿之间可清晰见到离散的管道。在积水形式的多囊病中，这些管道与类似肾盂的结构相连。在大体评估并打开囊肿顶部时，每个囊肿中可见一个小孔，有时可插入一根3.5F的饲管。
通常认为多囊肾代表一种囊肿不连通的情况。我们认为，大多数多囊肾中的囊肿是连通的，无论是否存在肾盂。
