Analysis of 39 Cases of Xanthogranulomatous Pyelonephritis with Emphasis on CT Findings
Analysis of 39 Cases of Xanthogranulomatous Pyelonephritis with Emphasis on CT Findings
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DOI：
10.1080/00365590310004752
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发表时间：
2003-01
影响因子：
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通讯作者：
I. Zorzos;V. Moutzouris;Georgios Korakianitis;G. Katsou
中科院分区：
文献类型：
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作者：
I. Zorzos;V. Moutzouris;Georgios Korakianitis;G. Katsou
目的：本文对39例黄色肉芽肿性肾盂肾炎（XGP）的临床、实验室及影像学特点进行回顾性分析。本文详细分析了XGP的CT特征，并复习了相关文献，以确定其中最具代表性的几种。材料与方法：回顾性分析39例XGP患者的病理资料，以确定其初步诊断。分析患者的既往病史、临床、实验室检查、尿路造影和CT表现、术前诊断、手术结果和术后时间。结果：弥漫型38例，局灶型1例。最常见的症状为发热、胁腹疼痛、寒战和不适。无功能肾和/或鹿角形结石是最常见的尿路造影结果。当可用时（15例），CT显示受累肾脏内多个充满液体的空腔，并证明所有病例的疾病扩展到肾周间隙。所有患者均接受了肾切除术，60%的病例的特征为困难，而2例患者发生了需要再次探查的术后并发症。结论：肾切除术治疗XGP可能伴随严重的并发症，适当的患者准备和手术计划非常重要。CT被认为是术前诊断该病的首选成像技术，迄今为止已经描述了大量的CT特征。肾实质内低密度液体充盈区和肾周浸润是XGP最典型的CT表现。
Objective: In this retrospective study a review of the clinical, laboratory and radiologic features of 39 cases of xanthogranulomatous pyelonephritis (XGP) is presented. CT characteristics of XGP are analyzed in detail and the relevant literature is reviewed in order to determine the most typical among them. Material and Methods: Pathologic material from 39 patients suffering from XGP was reviewed in order to confirm the initial diagnosis. Data compiled from the previous history of the patients, clinical, laboratory, urographic and CT findings, preoperative diagnosis, operative findings and postoperative period were analyzed. Results: Diffuse and focal forms of XGP were recognized in 38 and 1 cases, respectively. Fever, pain in the flank or abdomen, chills and malaise were the commonest symptoms. A non-functioning kidney and/or staghorn calculus were the commonest urographic findings. When available (15 cases), CT revealed multiple fluid-filled cavities in the affected kidney and demonstrated the extension of the disease to the perinephric spaces in all cases. All patients had undergone nephrectomies, which were characterized as difficult in 60% of cases, whereas two patients developed postoperative complications requiring re-exploration. Conclusions: Nephrectomy for XGP may be followed by severe complications and appropriate patient preparation and operation planning is of great importance. CT is considered the imaging technique of choice for diagnosing the disease preoperatively and a plethora of CT characteristics have been described to date. Low-density fluid-filled areas within the renal parenchyma and findings indicating perinephric extension should be considered the most typical CT features of XGP.