Urinary System Radiology

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Diffüz Renal Parankimal Hastalıklarda Radyolojik Görüntüleme
Radiological Imaging in Diffuse Renal Parenchymal Diseases
Feyza GELEBEKa
aGaziantep Üniversitesi Tıp Fakültesi, Radyoloji ABD, Gaziantep, TÜRKİYE
Gelebek F. Diffüz renal parankimal hastalıklarda radyolojik görüntüleme. Bayram MM, editör. Üriner Sistem Radyolojisi. 1. Baskı. Ankara: Türkiye Klinikleri; 2021. p.1-9.
Article Language: TR
ÖZET
Renal parankim, böbreğin korteks ve medullasını içeren fonksiyonel kısım olup böbrek parankim hastalığı; genetik, hemodinamik, toksik, enfeksiyöz ve otoimmun gibi geniş bir grup hastalık nedeniyle olabilmektedir. Renal parankimal hastalıklar glomerül ve tubulointersitisyumun intrinsik bozuklukları veya diabet, vaskulit, hipertansiyon gibi sistemik hastalıkların bir komponenti olarak da ortaya çıkabilirler. Akut böbrek yetmezliğinin en sık rastlanan sebebleri arasında böbreğin parankimal hastalıkları yer almaktadır. En sık neden akut tubuler nekroz'dur. Diğer nedenler arasında akut glomerulonefrit, renal kortikal nekroz, akut papiller nekroz, bilateral renal arter emboli ve trombozudur. Çocukluk çağında görülen böbrek yetmezliklerinin en sık rastlanılan nedenleri arasında akut ve kronik glomerulonefrit, hemolitik üremik sendrom, akut tubuler nekroz, kronik pyelonefrit ve bilateral hidronefroz rol alan faktörler olmaktadır. Böbrek hastalıklarının tanısı sıklıkla serum ve kanın biokimyasal analizi ile konulmakla birlikte böbrek hasarına neden olan farklı sebepleri ayırt etmek açısından duyarlılık ve özgüllüğü sıklıkla yetersizdir. Radyolojik görüntüleme çoğu böbrek parankimal hastalığında sınırlı bir role sahipken; sıklıkla nefrolitiasis, kistik hastalıklar, yer kaplayıcı lezyonlar ve obstrüktif nefropati tanısında kullanılmaktadır. Bunların dışındaki diğer renal parankimal hastalıklarda görüntüleme böbrek boyutu ve ekojenite- dansitesi hakkında bilgi vermektedir. Renal fonksiyon ve hasarı değerlendirmek için ileri görüntüleme yöntemleri gelecek vaat etmekte olup Fonksiyonel Manyetik Rezonans (fMR) görüntüleme teknikleri giderek daha fazla uygulanmaktadır. Fonksiyonel, moleküler ve hücresel değişiklikler anatomik değişikliklerden önce geliştiğinden, fMR görüntüleme, böbrek hastalığının erken dönemde saptanmasını ve hastalık patogenezinin daha iyi anlaşılmasını sağlayabilecektir.

Anahtar Kelimeler: Böbrek hastalıkları; tübüler nekroz; ultrasonografi
ABSTRACT
Renal parenchyma is the functional part that includes the cortex and medulla of the kidney and kidney parenchymal disease may be due to a large group such as genetics, hemodynamics, toxic, infectious and autoimmune. Renal parenchymal diseases can occur as a component of intrinsic disorders of glomeruli and tubulointerium or systemic diseases such as diabetes, vasculitis, hypertension. Most common cause of acute renal failure is parenchymal diseases of the kidneys. The most common cause of parenchymal diseases of the kidneys is acute tubular necrosis. Other causes include acute glomerulonephritis, renal cortical necrosis, acute papillary necrosis, bilateral renal artery embolism and thrombosis. Acute and chronic glomerulonephritis, hemolytic uremic syndrome, acute tubular necrosis, chronic pyelonephritis and bilateral hydronephrosis are common causes of renal failure in childhood. Although the diagnosis of kidney diseases is often made by biochemical analysis of serum and blood, its' sensitivity and specificity is often insufficient to distinguish different causes of kidney damage. While radiological imaging has a limited role in most kidney parenchymal diseases; It is often used in the diagnosis of nephrolitiasis, cystic diseases, space-occupying lesions and obstructive nephropathy. In other renal parenchymal diseases other than these, imaging provides information about kidney size and echogenicity-density. Advanced imaging methods are promising to assess renal function and damage, and functional magnetic resonance (fMR) imaging techniques are increasingly being applied. Since functional, molecular and cellular changes develop before anatomical changes, fMR imaging can provide early detection of kidney disease and a better understanding of disease pathogenesis.

Keywords: Kidney diseases; tubular necrosis; ultrasonography

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