肾盂输尿管交界处梗阻的X线诊断

Radiographic Diagnosis of Ureteropelvic Junction Obstruction

目的 :探讨肾盂输尿管交界处梗阻的X线表现及进一步提高诊断价值。材料和方法 :回顾性分析 5 0例经IVP及逆行造影 ,手术及病理证实的肾盂输尿管交界处梗阻病例的有关资料。结果 :肾盂输尿管交界处梗阻的病因比较复杂 ,可分为先天性和后天性 ,机械性和动力性等。本组病因 11种 ,占前四位的依次是炎性狭窄 ,先天性发育不良 ,迷走血管压迫和纤维索带压迫 ,例数在 5例以上 ;其它 1～ 4例。肾盂输尿管交界处梗阻造成的肾积水程度多较重 ,绝大多数为Ⅲ° Ⅳ° ,肾功能不同程度损害。结论 :逆性肾造影可作为静脉肾盂造影或大剂量静脉滴注肾造影检查肾脏显影不满意的一个常规检查方法 ,以明确肾盂输尿管交界处情况 ,可给临床提供较准确的病变部位。

Purpose: To improve the X-ray diagnostic accuracy of ureteropelvic junction obstruction. Materials and Methods: 50 cases of ureteropelvic junction obstruction confirmed by retrograde urogaphy, operation and pathology were analysed. Results: The causes of ureteropelvic junction obstrution were complicated. They could be divided into following categories: congenital or acquired diseases, mechanical or dynamic diseases. There were eleven causes in the study. The four major causes were inflammatory stricture, congenital maldevelopment, aberrant vascular compression and fibrosis compression. Most of hydronephrosis due to ureteropelvic Junction obstruction was severious (Ⅲ～Ⅳ°) and the damage to renal funtion varied with the degree of hydronephrosis. Conclusion: Rertograde urography is regarded as a routine technique for establishing the diagnosis while IVU is not satisfactory. In most cases, radiographic diagnosis is not the most available in ureteropelvic juntion obstrution but it can show proper location of the lesions.