肾造瘘顺行造影联合逆行肾盂造影对输尿管狭窄诊断的应用分析

The analysis on the Application of Anterograde Nephrostomy Combined with Retrograde Pyelography in the Diagnosis of Ureteral Stenosis

目的:分析肾造瘘顺行造影联合逆行肾盂造影(简称双向联合造影)对输尿管上段狭窄的诊断价值。方法:回顾分析49例经手术或CT尿路造影(CTU)证实的输尿管上段狭窄,且术前均已行肾造瘘顺行造影及逆行肾盂造影的患者,将双向联合造影执行先后顺序不同分成两组,顺序相同的分在同一组,对比两组病例的影像表现。结果:第一组:先逆行肾盂造影后肾造瘘顺行造影共28例,影像诊断符合率92.86%(26/28);第二组:先肾造瘘顺行造影后逆行肾盂造影共21例,影像诊断符合率71.43%(15/21)。结论:双向联合造影能明确诊断输尿管狭窄,准确显示狭窄位置及程度、肾积水及肾排泄功能情况,而且双向联合造影时先进行逆行肾盂造影诊断符合率更高,更准确。

Objective:To analyze the value of anterograde nephrostomy combined with retrograde pyelography(bidirectional combined angiography)in the diagnosis of upper ureteral stenosis.Methods:Retrospective analysis was made based on 49 patients who were diagnosed as upper ureteral stenosis through surgery or CT urography(CTU).Those patients had undergone both anterograde nephrostomy and retrograde pyelography before operation.The patients were divided into two groups according to the different sequence of bidirectional combined angiography implementation.Those did the same order were put into the same group and the image presentation of the two groups was compared.Results:In the first group,there were 28 cases which had retrograde pyelography before anterograde nephrostomy and the coincidence rate of imaging diagnosis for this group was 92.86%(26/28).In the second group,there were 21 cases which had anterograde nephrostomy before retrograde pyelography and the coincidence rate of imaging diagnosis for this group was 71.43%(15/21).Conclusions:Bidirectional combined angiography can clearly diagnose as ureteral stenosis,accurately display the location and degree of stenosis,hydronephrosis and renal excretion function.Moreover,having retrograde pyelography first in the bidirectional combined angiography could lead to a higher coincidence rate and be more accurate.