探讨血液病伴发急性肾损伤(AKI)患者肾脏以及肾周间隙的影像学特征。

回顾性分析2012年1月至2016年12月，唐山市人民医院(23例)和乐亭县医院(9例)血液科、肾内科，共收治的32例血液病合并AKI患者的腹部影像学检查资料。其中急性粒细胞白血病未分化型2例，急性淋巴细胞白血病3例，原发性巨球蛋白血症2例，真性红细胞增多症4例，多发性骨髓瘤17例，Pomes综合征2例，反应性单株免疫球蛋白增多症2例。所有患者行CT、磁共振(MR)平扫检查，由于患者均存在不同程度肾脏损害，为避免加重肾脏负担和预防对比剂肾病的发生，所有病例均未做增强扫描。

32例患者临床以及实验室检查均符合AKI诊断标准，影像学检查显示肾脏以及肾周间隙均存在异常改变；AKI影像学表现：双侧肾脏外形增大；多层螺旋CT(MSCT)表现为肾脏密度弥漫性减低；MR检查T1WI表现肾脏实质信号减低，T2WI肾脏实质信号弥漫性增高，STIR序列实质信号弥漫性增高；MSCT和MR均可见肾周间隙桥隔增粗，肾周间隙吉氏筋膜增厚，部分病例肾周间隙少量积液。

血液病伴AKI患者均存在肾脏以及肾周间隙异常影像学改变；通过分析血液病患者肾脏以及肾周间隙的异常影像学表现，影像科医生应提示临床医生警惕AKI的发生。

To investigate the imaging features of kidney and perirenal space in hematologic diseases patients with acute kidney injury (AKI).

Thirty-two patients in Tangshan People′s Hospital and Leting Country Hospital were selected from January 2012 to December 2016, and data on the abdomen imaging were retrospective analysed. Of them, 2 patients were undifferentiated acute myeloid leukemia, 3 cases were acute promyelocytic leukemia, 2 cases were primary macroglobulinaemia, 4 cases were polycythemia vera, 17 cases were genepal lymphadenomatosis of bones, 2 cases were Pomes, and 2 cases were reactive mononucleosis. All the patients were plain scanned by CT and MR without enhancement scanning, in order to avoid aggravating the burden of kidney and prevent the occurrence of contrast agent induced nephropathy.

Thirty-two cases were all in accordance with the AKI diagnostic criteria and had abnormal changes in the kidney and perirenal space. Imaging findings of AKI showed that the size of kidney was bigger, MSCT showed the density of kidney was lower. T1WI showed renal parenchymal signal reduced. T2WI showed renal parenchymal signal increased. STIR showed sequential parenchymal signal enhanced. MSCT and MR showed the bridging septate and fascia thicken and small effusion around the perirenal space.

There are abnormal imaging changes in kidney and perirenal space in AKI patients. By analyzing abnormal imaging findings in kidney and perirenal space, radiology doctors should alert clinicians to the occurrence of AKI.