延迟泌尿系CT成像在复杂性双侧输尿管异位开口畸形诊断中的应用

Delay CT urography for the diagnosis of complicated bilateral ectopic ureter malformation

目的提高输尿管异位开口畸形并尿失禁的诊断水平,减少漏诊病例的发生。方法回顾性分析2例输尿管异位开口畸形单侧手术后仍尿失禁患者的临床资料,结合文献复习输尿管异位开口畸形的诊断方法。结果两例患者在第一次住院手术前行泌尿系彩超、静脉尿路造影(IVP)、磁共振尿路造影(MRU)或泌尿系CT成像(CTU)检查,均只发现一侧的重复肾盂输尿管并异位开口畸形的存在,术后尿失禁症状仍然存在。第二次住院后分别通过延迟CTU检查,清楚显示出另一侧(未手术侧)"隐匿性"重复肾输尿管异位开口畸形的存在。结论延迟的CTU检查对于复杂性双侧重复肾输尿管异位开口畸形具有重要诊断价值,可以发现"隐匿性"重复肾输尿管畸形异位开口的存在,应作为重复肾输尿管畸形并异位开口患者的常规检查,对于减少临床漏诊率的发生有重要的临床意义,值得在有条件的医院推广。

Objective To improve the diagnostic level of ectopic ureter malformation and urinary incontinence, and reduce the occurrence of missed diagnosis. Methods The clinical data of 2 cases with ectopic ureteral orifice that persisted with urinary incontinence after operation were analyzed retrospectively and literatures were reviewed. Results Two patients before the first operation were diagnosed with urologic color doppler ultrasound, IVP, and MRI examination. Only one side of the renal duplication and ectopic abnormalities were found. Postoperative symptoms of urinary incontinence still existed. In the second hospital stay these patients received delay CTU examination that clearly showed the other side （non-operation side） ＂occult＂ renal duplication with ectopic ureter orifice. Conclusions Delay CTU examination has important value in the diagnosis of complicated bilateral ectopic ureter malformation. It can find the existence of ＂occult＂ renal duplication ectopic orifice, which should be used as a routine examination in patients of renal duplication and ectopic orifice. It has important clinical significance inreducing the miss diagnosis, and it is worthy of application in the hospital.