超声显像对先天性巨输尿管症的诊断价值

Diagnostic significance of ultrasonography for congenital megaureter

目的 探讨先天性巨输尿管症 (下称巨输尿管症 )的病理生理学改变与声像图表现的关系。方法对 16例 ( 2 0侧 )经静脉肾盂造影、手术和病理证实的巨输尿管症的超声显像结果进行分析。结果 16例 ( 2 0侧 )巨输尿管症输尿管内径最小 2 .0cm ,最大 4.7cm。超声显像诊断符合率 95 %( 19/2 0 )。根据 16例 ( 2 0侧 )巨输尿管症的病变累计范围和声像图不同 ,大致将其声像图表现分为三种类型 :①圆柱型 8例 ( 10侧 ) ,输尿管全程均呈圆柱状显著扩张 ,其中 6例 ( 8侧 )伴有迂曲 ;②纺锤型 6例 ( 8侧 ) ,以输尿管下段扩张为主 ,功能性狭窄段输尿管外形呈纺锤状 ;③鼠尾型 2例 ( 2侧 ) ,输尿管中下段扩张 ,张力较低的输尿管末端呈鼠尾状。结论 巨输尿管症的声像图表现与其病理生理学改变关系较密切 。

Objective To study the relation of pathophysiological changes and ultrasonographic appearances of congenital megaureter.Methods The ultrasonographic appearance and pathophysiological changes of 16 cases (20 sides) of congenital megaureter were reviewed.Results The accurate rate of ultrasonographic diagnosis was 95% (19/20),the inside diameter of megaureter ranging from 2.0 to 4.7 cm.According to difference of the involved ranges and ultrasonographic appearances of magaureter,three types can be classified.①Cylinder type: the ureteral dilatations were involved in the whole ureter and appear as cylinder shapes in 8 cases (10 sides),and of that 6 cases (8 sides) appears to be zigzagged.② Spindle type: the ureteral dilatations were localized mainly in the lower segment and appear as spindle shapes in 6 cases (8 sides),the narrow portions inferior and superior to dilated ureter appear to be functional.③ Rat tail type: the ureteral dilatations were localized mainly in the middle and lower segments and the terminal portion of low tension ureter appear as rat tail shapes in 2 cases (2 sides).Conclusions The ultrasonographic appearance and pathophysiological changes of congenital megaureter are closely correlated,therefore ultrasonography has important value in the diagnosis of congenital megaureter.