输尿管下段息肉的超声诊断价值

Ultrasonic diagnosis of low segment ureteral polyp

目的探讨超声诊断输尿管下段息肉的临床应用价值。方法对12例经输尿管镜或膀胱镜检查、病理检查证实为输尿管下段息肉(其中男性8例,女性4例,年龄17～60岁,平均年龄32.6岁;病程1个月～4年。左侧9例,右侧3例,合并输尿管结石4例,膀胱结石2例,肾结石1例,息肉自输尿管口部分脱入膀胱4例,随输尿管喷尿节律性脱入膀胱2例)的患者超声及临床资料进行回顾分析。结果超声对输尿管下段息肉的诊断符合率为58.3%(7/12)。误诊为输尿管癌3例,膀胱肿瘤2例,误诊率为41.7%(5/12)。其中合并输尿管结石4例,膀胱结石2例,肾结石1例。病理诊断为炎性增生性息肉9例,纤维性息肉3例。结论超声是输尿管下段息肉的首选筛查方法,对合并阴性结石、逆行造影困难、碘过敏者更具有价值。

Objective To study the clinical value of ultrasonic diagnosis for low segment ureteral polyp. Methods The ultrasonic and clinical data were analyzed retrospectively in 12 cases （male 8 cases ,female 4 cases,aged 17 to 60 years, mean age 32.6 years;duration of illness 1 month to 4 years. Left focus 9 cases,right 3 cases,combined with ureter stone 4 cases, bladder calculus 2 cases,kldnery stone 1 case） confirmed as ureteral polyp in low segment by cystoscopy/or ureteralscopy, operations and pathologyical examination. Results The diagnostic coincidence rate was 58.3 %（7/12） of ultrasonic approach in low segment ureteral polyp. Three cases were misdiagnosed as ureteral carcinoma and two cases as tumor of urinary bladder, thus the misdiagnostic rate was 41.7 % （5/12）. Of all cases there were 4 cases complicated with ureteral calculi,two cases with bladder stone and 1 case with renal stone. In pathological examination 9 cases of inflammatory hyperplastic polyp and 3 of fibroepithelial polyp were found. Conclusion Ultrasonic approach is the first choice for diagnosis low segment ureteral polyp, and it is more valuable in patients complicated with X-ray negative stone, difficult for retrograde urethrography and allergy to iodine.