傍腎盂嚢胞(Peripelvic cyst)の画像イメージ診断法

Abstract

Peripelvic cysts are uncommon comprising about 5% of all cystic diseases of the kidney, but are of great interest because of their diagnostic as well as therapeutic problems. Computed tomography, ultrasonography and renal scintigram using 99mTc-DMSA (dimercaptosuccinic acid) have been recently introduced as diagnostic image techniques of the kidney, and have changed a decision tree for renal mass lesions. Fifteen cases of peripelvic cysts seen at Kyoto University Hospital from the year of 1976 to 1979 were reviewed to evaluate retrospectively diagnostic accuracy of these new techniques, as compared to conventional roentogenographic examinations including angiography. The most valid methods for peripelvic cysts were computed tomography and ultrasonography. Renal scintigram and IVP were less effective. Angiography was the least valid. Ultrasonography is the most useful considering its ready availability, diagnostic accuracy for renal cysts, safety, economy, and non-invasiveness including X-ray. Direct needle punctures were not performed because of danger. Only 2 of 15 cases were operated and angiography were performed in 8 cases. After careful and total evaluation of these diagnostic studies, angiography and laparotomy can be dispensed, but watchful follow up at OPD is mandatory to rule out other diseases or malignancy.