影像学对肾盂输尿管交界处狭窄的诊断价值

The diagnostic value of imaging techniques for ureteropelvic junction stricture

目的探讨先天性肾盂输尿管交界处狭窄的影像学改变。方法选择符合标准的50例先天性肾盂输尿管交界处狭窄患者,分别行B超、泌尿系统平片(KUB)、静脉肾盂造影(IVP)及患侧逆行肾盂造影、CT平扫和增强扫描。结果肾盂输尿管交界区出现不同程度的狭窄,导致不同程度的梗阻及巨大肾盂积水,肾皮质变薄,肾盂扩大。结论综合分析影像学检查结果,运用程序,可采取先简后繁的原则,首选行B超检查,后行IVP检查及患侧逆行插管造影检查,有条件可以运用螺旋CT三维重建和MRI,均可达到目的。

Objective To study the image characteristics of congenital ureteropelvic junction stricture. Methods B ultrasonogTaphy, kid- neys, ureters, and bladder X-ray （KUB）, intravenous pyelography （IVP）, retrograde urography, and plain and enhanced CT scanning were performed in 50 cases of congenital ureteropelvic junction stricture. The image characteristics were analyzed. Results The images showed different degrees of stricture and obstruction in ureteropelvic junction, giant hydronephrosis with thin renal cortex and expanded renal pelvis. Conclusion Analysis of image results suggests image examinations may follow the order, i.e. B uhrasonography first, then IVP and retrograde urography. If a- vailable, three dimensional reconstruction of spiral CT and MRI can also be used for the diagnosis of ureteropelvic junction stricture.