【新整理】多囊性腎臟病變ppt課件(參考版)
2024-11-19 00:18本頁面
【正文】 (B) Two examples of the IVU appearances of ARPKD. The urogram should always be performed to demonstrate the caliceal pattern. This will demonstrate the typical radiating appearance of the contrast as it passes through the collecting system and help differentiate the dysplastic ‘bright’ kidneys.,A hepatic iminodiacetic acid (HIDA) scan should be performed at about 1 year of age. If performed too early the HIDA scan will be normal but, if delayed, the effects of the hepatic fibrosis will have had time to manifest. This involves a radioisotope tracer excreted in the bile and will demonstrate accumulation and stasis of isotope in the cystic areas and delayed clearance from the abnormal liver. A large left lobe of liver may also be seen.,CT and MRI are rarely needed except in uncertain cases (Fig. 3.34). DMSA scan is not always performed but may show focal defects in the kidney.,Figure 3.34 MRI examination in autosomal recessive polycystic kidney disease (ARPKD). This infant with ARPKD had an MRI because of apnoeic attacks. The examination was done to exclude a pulmonary artery sling, which was not present. The kidneys are huge,filling the abdomen and compressing the lungs. Note also the cystic areas in the liver, which are areas of bile duct dilation as seen in Figure 3.32.,。CYSTIC KIDNEYS,Cystic disease of the kidneys in childhood is a confusing and complicated subject. Also the complex and often contradictory nomenclature used to describe cystic kidneys is not an aid to understanding the subject. This section aims to provide the sonographer with a simple approach to cystic kidneys in children.,● Multicystic kidney or multicystic dysplastic kidney—this refers to many cysts in one kidney often containing some dysplastic elements. Not all multicystic kidneys are dysplastic. The condition is still considered to be nonhereditary. If the multicystic kidney is unilateral, the other kidney may be normal, hydronephrotic or dysplastic. If bilateral, it is incompatible with life, and infants die soon after birth with hypoplastic lungs and/or r
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