[1]李万婷,刘海燕,牛静,等.双侧肾外型肾盂伴左肾盂重度积水99Tcm-DTPA肾动态显像一例[J].国际放射医学核医学杂志,2018,(4):377-379.[doi:10.3760/cma.j.issn.1673-4114.2018.04.017]
　Li Wanting,Liu Haiyan,Niu Jing,et al.A case of bilateral extrarenal pelvis accompanied with severe hydronephrosis of left pelvis of 99Tcm-DTPA renal dynamic imaging[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):377-379.[doi:10.3760/cma.j.issn.1673-4114.2018.04.017]
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
期数:
2018年第4期
页码:
377-379
栏目:
病例报告
出版日期:
2018-07-25

文章信息/Info

Title:
A case of bilateral extrarenal pelvis accompanied with severe hydronephrosis of left pelvis of 99Tcm-DTPA renal dynamic imaging
作者:
李万婷;  刘海燕;  牛静;  崔雅丽;  武志芳;  刘建中
030001 太原, 山西医科大学第一医院核医学科
Author(s):
Li Wanting;  Liu Haiyan;  Niu Jing;  Cui Yali;  Wu Zhifang;  Liu Jianzhong
Department of Nuclear Medicine, the First Hospital of Shanxi Medical University, Taiyuan 030001, China
关键词:
肾外肾盂; 肾盂积水; 99m锝五乙酸盐; 放射性核素显像
Keywords:
Extrarenal pelvis; Hydronephrosis; Technetium Tc 99m pentetate; Radionuclicle imaging
DOI:
10.3760/cma.j.issn.1673-4114.2018.04.017
摘要:
笔者报道了双侧肾外型肾盂伴左肾盂重度积水99Tcm-DTPA肾动态显像一例。肾外型肾盂临床上通常无症状，常为健康体检或其他原因行腹部超声或CT等影像学检查时偶然发现，可伴有肾结石、肾积水等。因肾盂位于肾外，肾盂积水对肾皮质一般无压迫，故患者早期血尿素、血肌酐水平正常或轻度增高。临床为评估分肾功能，将9Tcm-DTPA肾动态显像作为首选检查，肾外型肾盂伴一侧肾盂重度积水表现为患侧肾影外异常显像剂浓聚影，需与尿漏、肾旋转不良等鉴别。故笔者通过病例及文献复习加深了对肾外型肾盂伴肾盂积水9Tcm-DTPA肾动态显像特点及鉴别诊断的认识。认识这种解剖变异和提供肾功能相关信息可以帮助临床医师做出决策，并降低术中损伤肾盏肾盂的风险。
Abstract:
The present case describes the 99Tcm-DTPA renal dynamic imaging of bilateral extrarenal pelvis accompanied by severe hydronephrosis of the left pelvis. The extrarenal pelvis is usually asymptomatic and is often found through abdominal examination via abdominal ultrasonography or CT scan. Hydronephrosis generally does not compress the renal cortex because the renal pelvis is located outside the kidney; thus, the patient’s early serum urea and creatinine levels are normal or slightly increased. 99Tcm-DTPA renal dynamic imaging is the clinicians’ first choice for evaluating left or right renal functions. Bilateral extrarenal pelvis, accompanied by severe hydronephrosis of pelvis, presents an abnormal concentration of 99Tcm-DTPA outside the renal area. This abnormality needs to be identified as urinary leakage or renal dysplasia. Therefore, we explored the characteristics of 99Tcm-DTPA renal dynamic imaging and the differential diagnosis of extrarenal pelvis with severe hydronephrosis in this study. Understanding this anatomical variation and providing information about renal functions can help clinicians make appropriate clinical decisions and reduce the risk of damage in the renal pelvis during surgery.

参考文献/References:

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[2] Nataraju G, Nandeesh BN, Gayathri MN. Extrarenal calyces:a rare anomaly of the renal collecting system[J]. Indian J Pathol Microbiol, 2009, 52(3):368-369. DOI:10.4103/0377-4929.54996.
[3] Gupta T, Goyal SK, Aggarwal A, et al. Extrarenal calyces:a rare renal congenital anomaly[J]. Surg Radiol Anat, 2015, 37(4):407-410. DOI:10.1007/s00276-014-1349-8.
[4] 苗新中, 段青松. 多层螺旋CT诊断肾外肾盂(附47例报告)[J]. 医学影像学杂志, 2012, 22(11):1904-1906. Miao XZ, Duan QS. Spiral CT diagnosis of extrarenal pelvis (report of 47 cases)[J]. J Med Imaging, 2012, 22(11):1904-1906.
[5] Filimonov VB, Vasin RV.[Pelvic dystopia of the left kidney with extrarenal position of the calycopelvic system with stricture of the pelvicoureteral segment complicated with hydronephrosis] [J]. Urologiia, 2011, 2:75-76.
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相似文献/References:

[1]查金顺,苏应瑞,蒋艳.131I-邻碘马尿酸盐肾图与肾盂积水和肾功能关系的探讨[J].国际放射医学核医学杂志,2009,33(5):268.[doi:10.3760/cnla.j.issn.1673-4114.2009.05.004]
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备注/Memo

备注/Memo:
收稿日期:2018-02-09。
通讯作者:刘海燕,Email:liuhaiyan-1203@126.com
更新日期/Last Update: 2018-07-25