静脉肾盂造影在小儿肾、输尿管重复畸形伴输尿管囊肿的应用

Application of intravenous pyelography in ureterocele children with renal and ureter duplication

目的探讨静脉肾盂造影(IVP)在小儿肾、输尿管重复畸形伴输尿管囊肿的应用。方法对20例肾、输尿管重复畸形伴输尿管囊肿患儿行IVP检查,其中9例患儿同时行CT尿路造影(CTU)。结果 20例患儿中,双侧重复肾4例,单侧重复肾16例,均伴输尿管囊肿。14个重复肾可见显影,IVP表现为上下排列的双肾盂或伴双输尿管。10个重复肾未显影或显影较差;其中,6个表现为下半肾受压下垂并远离脊柱;3个下半肾远离脊柱,积水扩张明显,与之相连的输尿管亦扭曲、扩张;1个正常显影的下半肾与脊柱间距不宽,上半肾延迟摄片仍显影浅淡。10个IVP未显影或显影欠佳的重复肾中均有不同程度的积水,CTU检查可清晰显示积水情况及输尿管囊肿。结论 IVP是诊断小儿肾、输尿管重复畸形伴输尿管囊肿的主要检查方法,在诊断不明时可行CTU补充检查。

Objective To investigate the application of intravenous pyelography(IVP) in ureterocele children with renal and ureter duplication.Methods IVP was performed in 20 ureterocele children with renal and ureter duplication,of whom 9 cases underwent computed tomography urography(CTU).Results Of 20 cases,4 cases were with bilateral repeated kidney and 16 cases with one-side repeated kidney,which were all with ureterocele.IVP showed that 14 cases with repeated kidney and double renal pelvis or ureter arranged up and down.Ten repeated kidneys were undeveloped or poorly developed and the lower half kidneys were pressed,of which 6 half kidneys were droped down and away from the spine,3 half kidneys were away from the spine with obvious seeper,expansion and twisted and dilated ureter,and one lower half kidney was imaged normally and not far from the spine,and the delayed film of the upper half kidney was still light.CTU clearly displayed hydronephrosis and ureterocele in 10 repeated kidneys,which were undeveloped or poorly developed with different degrees of seeper on IVP.Conclusion IVP is the main method in the diagnosis of renal and ureter duplication with ureterocele in children.CTU can be used as a supplementary examination when the diagnosis is uncertain by IVP.