泌尿系造影诊断下腔静脉后输尿管(附15例报告)

Diagnosis of retrocaval ureter using urography ( a report of 15 cases)

目的评价泌尿系造影在下腔静脉后输尿管诊断中的价值。方法回顾性分析１５例经手术证实的下腔静脉后输尿管。所有病例均行静脉尿路造影（ＩＶＵ）和逆行尿路造影（ＲＰ）检查，１２例行Ｂ超检查，２例行ＣＴ检查。结果经ＩＶＵ、ＲＰ、Ｂ超及ＣＴ检查，所有病例在术前均获得明确诊断。ＩＶＵ显示１０例上段输尿管扩张呈典型的反“Ｊ”状，３例呈“锥形”改变；ＲＰ显示输尿管导管呈“Ｓ”形；Ｂ超检查７例提示下腔静脉后输尿管；ＣＴ扫描显示下腔静脉与腹主动脉间圆点状输尿管充盈影。结论泌尿系造影检查是诊断下腔静脉后输尿管的可靠方法。

Objective To evaluate the diagnostic value and limitation of urography in retrocaval ureter.Methods 15 cases with retrocaval ureter confirmed by operation were retrospectively reviewed. Intravenous urography( IVU) and retrograde yelography (RP) were performed in all cases;12 cases underwent ultrosonographic examination; 2 cases also had CT examination. Results All cases were definitely diagnosed by urography、ultrosonography and computed tomography before operation. On IVU, the dilation of the right pelvicalyceal system and upper ureter formed a characteristic reversed J shape in 10 cases and tapering in 2 cases. On RP, the catheter presented S shaped appearance. Ultrosonography suggested the diagnosis of retrocaval ureter in 7 cases. CT scan revealed opacification of ureter posterior to inferior vena cava, and scan at lower level revealed the ureter medial to vena cava and just anterior to vertebral body. Conclusions Urography is a reliable method for the diagnosis of retrocaval ureter.