先天性巨输尿管症的X线与超声诊断(附19例分析)

The diagnostic imaging of congenital megaureter:report of 19 cases

目的 :探讨X线与超声对先天性巨输尿管症的诊断价值。方法 :回顾性分析了 19例先天性巨输尿管症的静脉肾盂造影 (IVP)、尿路逆行造影及超声影像资料。 19例先天性巨输尿管症均进行了尿路造影和超声检查。其中 3例术前做了CT检查 ,本组病例均经手术及病理证实。结果 :巨输尿管症以其下端管腔无机械性梗阻的相对狭窄和狭窄段以上显著性扩张为特征。成人的扩张多不延及肾盂肾盏 ,小儿多数病例有肾盂肾盏扩张积水表现。早期扩张的下段可呈“纺锤状”或“杵状”。尿路造影透视和超声实时观察时 ,可见扩张输尿管蠕动频率减慢、幅度增大、向下传递间断。结论 :超声因其具有诸多优点 ,可作为诊断巨输尿管症的首选的筛查方法。尿路造影检查 ,正确诊断率高 ,为本症术前的必查项目。两种检查方法联合应用可优势互补。

Objective:To explore the diagnosis value of X-ray and ultrasound examination for congenital megaureter.Methods:The findings of X-ray,intravenous urography(IVP) and reversal urography in 19 cases with congenital megaureter were analyzed retrospectively.Three cases were also examined by CT.Results:All the cases in this group had been confirmed by operation.Congenital mgaureter was characerized by the relative stricture of the terminal end of the ureter without mechanic obstruction and the significant dilation above the stricture.While pyelography showed that the dilation did not involve the kidney in adulthood,the manifestation was different in childhood.In most circumstanes,pyelography could show dilation and hydrocele of the kidney.In early stage,the segment below the dilation appeared as drumstick-shape or spindle-shape.On the observation under the reversal urography and ultrasound,the movement of the segment of dilation slowed down,but the range of movement increased and the transfer of the movement was interrupted.Conclusion:Intravenous urography is the main method in the diagnosis of congenital megaureter,ultrasound examination possess much advantages is also the first screening method due to its merit,combinig these two methods complementally is adequate.