女童输尿管异位开口侧肾脏的定位诊断(附58例报告)

Localization assessment of kidney with ectopic ureter:analysis of 58 girls

目的 探讨女童输尿管异位开口侧肾脏的定位诊断 ,为术式选择提供依据。 方法 对 5 8例患儿的临床表现、IVU、B超及SPECT影像学和膀胱镜检查结果进行综合分析。 5 8例平均年龄 3.4岁。根据文献 [1]分型 ,Ⅰ型 5例 ,Ⅲ型 4 2例 ,Ⅳ型 1例 ,Ⅴ型 8例 ,Ⅵ型 2例。 结果 经手术证实Ⅲ型输尿管异位开口IVU确诊率为 95 % (40 /42 )。B超为 2 7% (12 /5 3) ,SPECT为 37% (6 /16 )。综合分析影像学及膀胱镜检查结果 ,准确定位诊断率为 98% (5 7/5 8)。 结论 相关结果综合分析有助于提高诊断准确率 ,除Ⅲ型输尿管异位开口外 ,膀胱镜检查是不可替代的检查方法。

Objective To present the means of localizing the kidney with ectopic ureter in order to provide the reliable ground for surgical strategy. Methods Clinical manifestation study,IVU,SPECT imaging and cystoscopy were conducted.All the 58 patints are female with a mean age of 3.4 years.According to the creteria presented in reference,5 were type Ⅰ,42 type Ⅲ,1 type Ⅳ,8 type Ⅴ and 2 type Ⅵ. Results Operative finding revealed the accurate localization and diagnosis rate of IVU has been 95%(40/42) in type Ⅲ ectopic ureter,B-ultrasonograph 27%(12/53),SPECT 37%(6/16).With the combined consideration of imaging procedures and cystoscopy,the accurate localization and diagnosis rate has been 98%(57/58). Conclusions Combined use of imaging procedures and cystoscopy would improve the localization and diagnosis rate.Cystoscopy is the most reliable except in type Ⅲ ectopic ureter.