101例先天性泌尿系畸形的影像学研究

Imaging findings on 101 cases with congenital urinary malformations.

目的探讨泌尿系统水成像MRU与分泌性ce-MRU的方法,并讨论其适应证,评价其优劣;描述泌尿系统先天性畸形类型及其影像学表现。方法回顾性分析101例先天性泌尿系统畸形的影像学表现。所有病例均实行MR水成像扫描;其中86例同时行水成像MRU与注射对比剂的ce-MRU对照。结果101例MR共发现11种泌尿系畸形、156个病灶。无论泌尿系有无排泌功能,MRU均能显示有尿液或囊液充盈或扩张的部位;ce-MRU能显示有功能的肾脏并与之相连的正常或病变的泌尿管道。结论水成像MRU能清楚显示所有尿液充盈的正常结构或积液扩张的病灶;ce-MRU能显示有功能的肾脏并与之相连的正常或病变的泌尿管道、膀胱,以及病变与周围血管的关系;MRU与ce-MRU应相互结合使用,为临床治疗提供十分完整有用的影像学资料。

Objective To discuss the methods and indications of MR urography and contrast enhanced MR urography （ce -MRU） and evaluate their advantages and disadvantages, as well as depict the types and their imaging findings of congenital urinary malformations. Methods Retrospectively analyze the imaging findings of 101 cases with congenital urinary malformations. MR urography were conducted on all the cases; among which 86 cases were 1. 25mm - slice scanned with injection of Gd - DTPA and analyzed with MIP reconstruction （ so called ce - MR urography）. Results 186 lesions among 11 categories of urinary malformations found in 101 cases. MR urography could display all the normal compositions and lesions abounded with urine or cystic fluid, while the ce - MRU could display functional kidney tissues and contrast enhanced ducts and cavities. Conclusion MR urography could dis- play all the enlarged urinary malformations, such as hydronephrosis, dilated ureters and its cysts without contrast agent, no matter that the kidney is functional or not. Ce - MRU could display those lesions connected with functional kidneys. MRI can provide valuable information for surgery with the combination of MRU and ce - MRU.