Renal Abscess-Current Concepts of Diagnosis

腎臟膿瘍是一種較少見，但對生命威脅很大的疾病，在以往由於正確診斷率很低，以致死亡率相當高。由臨床表徵，實驗室檢驗結果及靜脈腎盂攝影很難將它與其他腎臟發炎疾病或腫瘤區分。本院在近三年共有六例腎臟膿瘍患者，每位病患皆接受腹部超音波及電腦斷層掃描檢查，其中有三例亦接受腎血管攝影術檢查。此六例都進一步在超音波引導下接受經皮膚抽取引流術診斷並證實之。電腦斷層掃描能正確診斷出此三例腎臟內膿瘍及三例腎周圍膿瘍之病例，而超音波檢查及腎血管攝影檢查為正常的患者（偽陰性）各有一例。由於腎血管攝影術為侵入性檢查且對腎膿瘍之診斷幫忙不大，故只有在懷疑病灶為惡性腫瘤之機會較大峙，才考慮施行。對於腎臟膿瘍的診斷而言，電腦斷層是較靈敏和準確的方法，且對膿瘍的範圍及腎周遭的解剖關係，提供了非常大的幫忙，而經皮膚抽取引流術除了是確定診斷的必需方法外，亦為腎臟膿瘍治療的有效方法之一。

關鍵字

腎臟內；腎周圍膿瘍；電腦斷層掃描；經皮膚膿瘍抽取術

並列摘要

Intrarenal and perinephric abscesses remain a significant source of morbidity and mortality, as well as, a diagnostic dilemma in the past. The Clinical pictures, laboratory data and excretory urography could not further differentiate between inflammatory lesions and neoplastic processes. However, the new imaging modality as ultrasound and computerized tomography could make the diagnosis firmly. Six patients with renal abscesses were presented and evaluated with sonography and computerized tomography (CT). Renal arteriography was performed in three patients. All six cases were proven with percutaneous aspiration under ultrasound guidance. CT correctly diagnosed all intrarenal (three) and perinephric (three) abscesses. There is a false negative case diagnosed by ultrasound. Although renal angiography may aid in the differential diagnosis with renal tumors, but it is usually unnecessary. Based on our limited experience, CT is the more sensitive diagnostic modality of choice for renal abscess and percutaneous aspiration of renal abscess is a more precise and definitive diagnostic procedure.

並列關鍵字

Intrarenal ； Perinephric abscess ； Computerized tomography (CT) ； Percutaneous aspiration

國際替代計量

Renal Abscess-Current Concepts of Diagnosis

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