输尿管狭窄的影像学分析

The Imaging Analysis of Ureteral Stenoses

目的:探讨输尿管狭窄的原因及影像学诊断价值。方法:回顾性分析58例经手术病理证实为输尿管狭窄患者的影像学资料。IVP检查58例,RPP检查15例,US检查51例,CT检查12例,MRU检查6例。结果:58例均显示狭窄部位,其中IVP显示48例(48/58),RPP显示15例(15/15),US显示16例(16/51)CT显示12例(12/12),MRU显示6例(6/6)。肾盂输尿管移行部狭窄36例,其它部位22例。单侧狭窄54例,双侧狭窄4例。先天性狭窄24例,炎性狭窄17例,血管或纤维索带压迫13例,其它原因4例。IVP、RPP、US、CT、MRU检查对输尿管狭窄的定位与手术的符合率均为100%,对狭窄的原因诊断与手术病理的符合率分别为71%、73%、63%、83%、67%。结论:影像学检查是发现输尿管狭窄有效的检查方法,常规以静脉尿路造影为主。

Objective To explore the reason of ureteral stenoses and the value of imaging in ureteral stenotic diagnosis. Methods Fifty -eight cases with ureteral stenoses proved surgically and pathologically were analyzed ,retrospectively. Fifty -eight cases with IVP, 15 cases with RPP ,51 cases with US, 12 cases with CT,6 cases with MRU were evaluated. Results All the ureteral stenoses were demonstrated in 58 cases, 48 were reported with IVP, 15 with RPP, 16 with US, 12 with CT, 6 with MRU. The most common sites were the superior stricture （36/58）, other sites 22 cases; unilateral stenoses 54 cases,bilateral stenoses 4 cases; congenital ttreteral stenoses 24 cases, inflammatory stenoses 17 cases, compression by vessel or fibroplasia 13 cases, other reasons 4 cases. The stenotic sites demonstrated with IVP, RPP, US,CT,MRU was accorded with that in operation, the corresponding rate between IVP, RPP, US, CT, MRU and surgical pathology was 71%, 73% ,63% ,83% ,67% ,respectively ,in ureterostenosis etiological diagnosis. Cornclusion The useful approach of diagnosing ureteral stenoses is imaging,IVU should be the first choice.