经会阴部后尿道结石的超声诊断

Value of Perineal Ultrasound in Diagnosis of Posterior Urethral Calculi

目的探讨后尿道结石患者的超声声像图特点及诊断。方法对52例后尿道结石患者应用经会阴部超声检查,观察后尿道结石的形态、大小、回声、位置及结石与周边组织的关系。结果 52例患者共有后尿道结石53处(尿道内口31处,前列腺部9处,膜部13处),其中1例尿道内口及膜部各见一处结石。结石的形状多呈米粒状、椭圆状及小长条状;结石较大的为1.7 cm×0.9 cm,较小的为0.6 cm×0.5 cm,常伴弱声影,与尿道周围组织分界清晰。经腹部超声后尿道结石的检出率为79.24%,经会阴部超声后尿道结石的检出率为92.45%,二者比较差异有统计学意义(P<0.05)。结论经会阴部超声检查安全、简便及重复性好,对后尿道结石的诊断及治疗效果能做出准确诊断及治疗,有着重要的临床意义。

Objective To study the characteristics and value of uhrasonography in the diagnosis of posterior urethral calculi. Methods Perineal ultrasound was performed in 52 patients with posterior urethral calculi. The shape, size, echo and position of calculus and its relation to surrounding tissue were observed. Results Among the 52 patients, 31 had internal urethral orifice stones, 9 had prostatic stones, and 13 had peritoneal stones （1 patient had both internal urethral orifice stones and peritoneal stones）. Most stones showed rice-shaped, oval-shaped and small, long and strip-shaped outlines. The larger and smaller sizes of stones were 1.7 cm^0.9 cm and 0.6 cm^0.5 cm, respectively. In addition, stones often produced weak acoustic shadow and showed clear demarcation between posterior urethral calculi and periurethral tissue. The detection rate by using perineal ultrasound was significantly higher than that by using abdomen ultrasound （92.45% vs 79.24%, P〈0.05）. Conclusion Perineal ultrasound is safe, simple and reproducible and has important clinical significance for the diagnosis and treatment of posterior urethral calculi.