移植肾输尿管梗阻的超声诊断

Ureter Obstruction in Renal Transplantion: Evaluation with Ultrasonography

目的 提高超声对移植肾输尿管梗阻的诊断水平 ,对在 75 8例次肾移植患者中经二维超声发现的 2 3例次移植肾输尿管梗阻病例进行总结分析。方法 应用二维超声经腹壁对移植肾及输尿管进行检查 ,发现肾盂扩张积水者 ,换用高频探头重点扫查输尿管管壁及管腔 ,并进行动态观察。结果 三种类型梗阻均有肾肿大和肾盂扩张积水 ,以狭窄性为最重。其中狭窄性梗阻 14例次 ,结石性梗阻 8例次 ,外压性梗阻 1例。结论 二维超声是诊断移植肾输尿管梗阻的首选方法 ,对结石性和外压性梗阻可明确诊断 ,对狭窄性梗阻可结合肾图、经皮造瘘管顺行造影来确诊。

Objective This study is performed to improve the diagnosis of ureter obstruction in renal transplantation, 2 dimentional ultrasonography findings in 758 patients were reviewed. Methods All the patients were examined by 2 dimentional ultrasound transabdomen, the patients with ureter obstruction were examined by high frequency probe to observe the lumen and wall of the ureter dynamically. Results Three typies of ureter obstruction with renalmegaly and hydronephrosis were found, the stenosis type was most severe. Among these patients, there were 14 cases of obstruction with ureter stenosis, 8 cases of obstruction with stone, 1 case with outside press. Conclusion 2 dimentional ultrasound is a chief method in examination of ureter obstruction in renal transplantation, the obstruction with stone and outside press can be diagnosed, and with renography and percutaneous fistula radiography, the obstruction with stenosis also can be diagnosed. [