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泌尿系各种异常影响学表现 .doc
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    孤立肾

    Unilateral renal

    agenesis

    (solitary kidney)

    (Fig GU 1-1)

    Filling of the renal fossa with

    bowel loops (sharply outlined

    gas or fecal material in the

    plane of the renal fossa on

    nephrotomography). The

    contralateral kidney usually

    shows compensatory

    hypertrophy.

    Rare anomaly that is associated

    with a variety of other congenital

    malformations. It is essential to

    exclude a nonfunctioning,diseased kidney by ultrasound or

    CT. After nephrectomy, the renal

    outline is generally preserved on

    plain films if the perinephric fat is

    left in situ.

    异位肾

    Renal ectopia

    (Fig GU 1-2 and Fig GU

    1-3)

    Abnormally positioned kidney

    that can be found in various

    locations. The ectopic kidney

    usually functions, though the

    nephrogram and

    pelvocalyceal system may be

    obscured by overlying bone

    and fecal contents.

    Includes pelvic kidney,intrathoracic kidney, and crossed

    ectopia (the ectopic kidney lies on

    the same side as the normal

    kidney and is usually fused with

    it). Whenever only one kidney is

    seen on excretory urography, a

    full view of the abdomen is

    essential to search for an ectopic

    kidney.

    旋转不良

    Malrotation

    (Fig GU 1-4)

    Often bizarre appearance of

    the renal parenchyma,calyces, and pelvis that may

    suggest a pathologic condition

    in an otherwise normal kidney.

    Unilateral or bilateral anomaly.

    When the renal pelvis is situated

    in an anterior or lateral position,the upper part of the ureter often

    appears to be displaced laterally,suggesting an extrinsic mass. The

    elongated pelvis of a malrotated

    kidney may mimic obstructive

    dilatation.

    马蹄肾

    Horseshoe kidney

    (Fig GU 1-5)

    Characteristic urographic

    features include vertical or

    reversed longitudinal axes of

    the kidneys (upper poles tilted

    away from the spine),demonstration on the

    nephrogram phase of a

    parenchymal isthmus (if

    present) connecting the lower

    poles, and projection of the

    lower calyces medial to the

    upper calyces on frontal

    views. The large and flabby

    pelves may simulate an

    obstruction.

    Most common type of fusion

    anomaly. Both kidneys are

    malrotated, and their lower poles

    are joined by a band of normal

    renal parenchyma (an isthmus) or

    connective tissue. True

    ureteropelvic junction obstruction

    may develop because of the

    unusual course of the ureter,which arises high in the renal

    pelvis, passes over the isthmus,and may kink at the ureteropelvic

    junction.

    肝/脾肿大

    Hepatomegaly/splenomegaly

    (Fig GU 1-6)

    Downward displacement of a

    kidney.

    Liver enlargement almost always

    causes downward displacement

    of the right kidney.

    肾外肿块向下推挤肾脏

    Intraor extrarenal masses

    Downward

    displacement

    (Fig GU 1-7)

    Direction of displacement of

    the kidney depends on the

    type of underlying mass.

    Adrenal tumor or hemorrhage;

    large upper pole intrarenal mass.

    Splenomegaly infrequently causes

    downward and medial

    displacement of the left kidney.

    向上移位

    Upward displacement

    (Fig GU 1-8)

    Small liver (high right kidney in

    advanced cirrhosis with a

    shrunken liver); Bochdalek's

    hernia (intrathoracic kidney);

    lower pole intrarenal mass.

    内侧移位

    Medial displacement

    (Fig GU 1-9)

    Splenomegaly; large

    extracapsular or subcapsular

    renal mass (hematoma, lipoma).

    移植肾

    Transplanted kidney

    (Fig GU 1-10)

    Kidney overlies the ilium. Evidence of surgical clips or

    markers.

    肾缺血

    Renal ischemia

    (Fig GU 2-1)

    Small, smooth kidney.

    Unilateral delayed

    appearance and excretion of

    contrast material with

    subsequent

    hyperconcentration. There

    may be ureteral notching (due

    to collateral arteries) and

    vascular calcification.

    Chronic ischemia

    (usually arteriosclerosis

    or fibromuscular

    hyperplasia) causes

    tubular atrophy and

    shrinkage of glomeruli.

    Often associated with

    hypertension, which is

    likely if the right kidney is

    at least 2 cm shorter

    than the left or if the left

    kidney is at least 1.5 cm

    shorter than the right.

    May be bilateral if there

    is generalized renal

    arteriosclerosis.

    慢性肾梗死

    Chronic (total) renal infarction

    (Fig GU 2-2)

    Global shrinkage of the kidney

    with absent opacification.

    There may be a peripheral rim

    of opacified cortex during the

    nephrogram phase (probably

    reflects viable renal cortex

    perfused by perforating

    collateral vessels from the

    renal capsule).

    Renal occlusion is most

    commonly secondary to

    an embolism from the

    heart. A decrease in

    renal size is detectable

    within 2 weeks and

    reaches its maximum

    extent by 5 weeks.

    Compensatory

    enlargement of the

    contralateral kidney (in

    individuals young enough to provide this

    reserve).

    放射性肾炎

    Radiation nephritis

    (Fig GU 2-3)

    Progressive ischemic atrophy

    and decreased function

    produce a unilateral small,smooth kidney with some

    decrease in renal function.

    Diffuse renal ischemia

    and vasculitis are due to

    inclusion of the kidney in

    the radiation field. Tends

    to become apparent

    after a latent period of 6

    to 12 months. The

    threshold dose is

    approximately 2,300

    rads over a 5-week

    period.

    先天性发育不全

    Congenital hypoplasia

    (Fig GU 2-4)

    Small, smooth kidney with five

    or fewer calyces and an

    enlarged contralateral kidney

    (compensatory hypertrophy).

    Generally good function with a

    normal relation between the......（后略) ......