CAJ | 학술논문

目的探讨头孢曲松钠相关尿路假性结石的CT影像特点. 方法回顾性分析2008年8月至2012年4月收治的3例头孢曲松钠相关尿路假性结石患者的资料,并结合文献分析该病的CT影像特点.男2例,女1例.年龄分别为9、21、55岁.1例因阑尾炎、2例因泌尿系感染行头孢曲松钠抗感染治疗.1例于用药第13天出现腰腹部疼痛;1例第2天出现腰痛加重伴尿中出现棉团状物,第3天发展为无尿;1例第5天尿中出现絮状物.3例用药后的CT检查均显示尿路内异常高密度影.1例无尿患者行输尿管镜下碎石+经皮肾镜取石术治疗;另2例行CT随诊,其中1例停药后16d高密度影消失,1例停药后12d高密度影明显减少,此后未继续随诊. 结果 3例头孢曲松钠相关尿路假性结石在CT上表现为高密度影,CT值47 ～ 667 HU,除1枚输尿管结石密度不均外,其他密度较均匀.假性结石同时累及肾、输尿管和膀胱2例,同时累及肾和膀胱1例;2例伴有肾、输尿管积水,1例合并胆囊假性结石.肾假性结石均为多发,2例呈结节状,1例伴有积水者呈泥沙状及结节状.输尿管部位1例发生4枚,1例2枚,其中5枚呈条柱状,1枚呈小结节状.膀胱部位1例单发,呈小结节状;2例多发,1例呈泥沙状,另1例共2枚,呈小结节状. 结论头孢曲松钠相关尿路假性结石的CT影像特点为双侧尿路多部位多发、密度较均匀的高密度影,其在输尿管内多呈条柱状,在肾及膀胱呈泥沙状或结节状.
목적 탐토두포곡송납상관뇨로가성결석적CT영상특점. 방법 회고성분석2008년8월지2012년4월수치적3례두포곡송납상관뇨로가성결석환자적자료,병결합문헌분석해병적CT영상특점.남2례,녀1례.년령분별위9、21、55세.1례인란미염、2례인비뇨계감염행두포곡송납항감염치료.1례우용약제13천출현요복부동통;1례제2천출현요통가중반뇨중출현면단상물,제3천발전위무뇨;1례제5천뇨중출현서상물.3례용약후적CT검사균현시뇨로내이상고밀도영.1례무뇨환자행수뇨관경하쇄석+경피신경취석술치료;령2례행CT수진,기중1례정약후16d고밀도영소실,1례정약후12d고밀도영명현감소,차후미계속수진. 결과 3례두포곡송납상관뇨로가성결석재CT상표현위고밀도영,CT치47 ～ 667 HU,제1매수뇨관결석밀도불균외,기타밀도교균균.가성결석동시루급신、수뇨관화방광2례,동시루급신화방광1례;2례반유신、수뇨관적수,1례합병담낭가성결석.신가성결석균위다발,2례정결절상,1례반유적수자정니사상급결절상.수뇨관부위1례발생4매,1례2매,기중5매정조주상,1매정소결절상.방광부위1례단발,정소결절상;2례다발,1례정니사상,령1례공2매,정소결절상. 결론 두포곡송납상관뇨로가성결석적CT영상특점위쌍측뇨로다부위다발、밀도교균균적고밀도영,기재수뇨관내다정조주상,재신급방광정니사상혹결절상.
Objective To investigate the CT imaging features of urinary tract ceftriaxone-associated pseudolithiasis.Methods The CT imaging data of three patients with ceftriaxone-associated pseudolithiasis were collected from August,2008 to April,2012.Their data combined with related literatures were used to review CT imaging features of urinary tract pseudolithiasis.Those three patients,including 2 males and 1 female,were 9,21 and 55 years old,respectively.Ceftriaxone sodium was administrated to one patient due to appendicitis and the other two patients due to urinary tract infection.After ceftriaxone treatment,1 case began to have backache and abdominal pain on day 13,1 case presented backache with floc in the urine on day 2 and progressed to anuria,and the other one had cotton-like material in the urine on day 5.Urinary tract high density shadows were found in all patients by CT scan.The patient with anuria was treated with ureteroscopic lithotripsy and percutaneous nephrolithotomy.The other 2 cases were arranged to be followed up with CT scan.In those cases,the CT showed that the high density shadow in one patient disappeared 16 days after drug discontinuation.The high density shadow was significantly reduced 12 days after ceftriaxone withdrawal in the other one.However,no follow-up was performed afterwards.Results All the urinary tract ceftriaxone-associated pseudolithiasis presented the high density shadows on CT,with CT value 47-667 HU.The density of CT results is homogenic,except one ureteral stone.The pseudolithiasis,existed in kidney,ureter and bladder simultaneously,were found in two patients.And the other patient was found that the pseudolithiasis existed in both kidney and bladder.Two cases were accompanied with hydroureter and hydronephrosis and the other case were accompanied with cholecystolithiasis.The multiple renal pseudolithiasis was noticed in 2 cases,which exhibited the nodular shape.And one patient with hydronephrosis presented both sand-like and nodular stones.Ureteral pseudolithiasis was found in 1 case with 4 stones and the other one with 2 stones.In those pseudolithiasis,5 appeared column morphology and one showed nodular shape.The single nodular stone in bladder was found in one case.And the multiple bladder stones were found in 2 cases.Conclusions The CT imaging characters of urinary tract ceftriaxone-associated pseudolithiasis are high homogenic density shadows in multiple parts of bilateral urinary tracts.The ceftriaxone-associated pseudolithiasis is column shape in ureter and sand-like or nodular shape in kidney and bladder.