影像学检查在肾积液性质鉴别诊断上的研究进展

Research Progress on the Diagnostic Efficacy of Imaging Examinations in Differentiating the Nature of Hydronephrosis

摘要: 目的：肾积液(即肾积水)为泌尿系统梗阻导致的肾盂、肾盏内部潴留尿液并形成扩张的液腔。在肾积水进一步感染后导致肾组织坏死，积液由尿液转变为脓液后形成肾积脓。对肾积脓的诊断现阶段仍以穿刺引流出脓性为金标准。二者由于临床症状较为相似，但肾积脓对患肾损伤较大，如何在疾病早期依靠影像学特征对肾积水和肾积脓进行无创鉴别诊断以挽救肾功能非常重要。本文对近年来影像学检查在肾积液性质鉴别诊断效能上的研究进展进行综述，旨在为临床开展进一步治疗方案提供思路及参考。

Abstract: Objective: Hydronephrosis refers to the dilation of the renal pelvis and calyces due to urinary retention caused by obstruction within the urinary system. When hydronephrosis is contaminated by infection, necrosis of the renal tissue may occur, and the retained urine can transform into pus, resulting in pyonephrosis. At present, the gold standard for diagnosing pyonephrosis is the aspiration and drainage of purulent fluid in surgery. Although the clinical manifestations of hydronephrosis and pyonephrosis are often similar, pyonephrosis causes more severe damage to the affected kidney. It is crucial to achieve non-invasive differential diagnosis between hydronephrosis and pyonephrosis at an early stage using imaging features for renal function preservation. This article reviews recent advances in imaging techniques for distinguishing the nature of hydronephrosis, aiming to provide insights and references for further clinical treatment strategies.