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目的分析儿童急性局灶性细菌性肾炎(acute focal bacterial nephritis,AFBN)的多层螺旋CT(MSCT)表现特征,探讨MSCT对AFBN的诊断及鉴别诊断价值。资料与方法经临床证实的12例AFBN患儿均行CT平扫及增强扫描,并行冠状位多平面重组(MPR)、容积再现(VR)、最大密度投影(MIP)重组,观察双侧肾脏形态、密度改变以及实质的灌注情况。12例尿培养均呈阳性。结果 CT表现分两型:典型者表现为单/双侧肾脏形态增大,实质灌注减低伴多发“楔”形或片状病灶,底部朝向肾外,尖端指向肾盂;不典型者肾脏内病灶呈肿块状,多单发,不均匀强化。结论 MSCT特别是增强扫描对于诊断儿童AFBN有一定优势,有助于提高对病变的诊断准确率。
Objective To analyze the multi-slice spiral CT (MSCT) features of children with acute focal bacterial nephritis (AFBN) and to explore the value of MSCT in the diagnosis and differential diagnosis of AFBN. Materials and Methods All 12 clinically proven AFBN patients underwent CT scan and contrast-enhanced scan. Coronal MPR, VR and MIP were performed to observe bilateral renal morphology , Density changes, and substantial perfusion. 12 cases of urine culture were positive. Results The CT manifestations were divided into two types: typical ones showed single / bilateral kidney morphology increased, substantial perfusion decreased with multiple “wedge” or flake lesions, the bottom toward the kidney, the tip pointed to the renal pelvis; atypical kidney Lesions showed mass, single hair, uneven enhancement. Conclusion MSCT, especially enhanced scan for the diagnosis of children with AFBN have some advantages, help to improve the diagnostic accuracy of lesions.