二维超声及彩色多普勒血流显像对输尿管结石的诊断价值

Two-dimensional Ultrasonography and Color Doppler Flow Imaging Diagnosis of Uretal Calculi

目的 探讨二维超声及彩色多普勒血流显像 (CDFI)对输尿管结石的诊断价值和对第二狭窄处结石的定位显示及非梗阻型结石的显像特征。方法 超声检查前饮水 3 0 0～ 5 0 0ml或口服速尿 ( 2 0mg) ,于 3 0min后施行超声检查 ,并与X线检查、体外震波碎石、腔内震波碎石、药物排石及手术病理进行对照 ,根据声像图特征进行回顾性分析。结果 3 68例输尿管结石 ,经X线检查、手术、体外震波碎石、腔内震波碎石和药物排石证实完全符合。第二狭窄处的结石与髂总动脉或髂外动脉的关系清晰可见。CDFI :结石周边呈五彩镶嵌的彩色尿流信号。结论 第二狭窄处结石可根据髂动脉准确定位。非梗阻型结石沿输尿管走行方向 ,借助其毗邻关系寻找可疑光团 ,用CDFI鉴别。因此 ,二维超声与CDFI联合应用 ,不仅可有效地检出各段输尿管结石 。

Objective To assess the value of two-dimensional ultrasonography (2DUS) and color Doppler flow imaging (CDFI) in diagnosing uretal calculi, especially the calculi positioned at the second narrow part and the image features of non-obstructing calculi.Methods The patients were administrated by 20 mg furosemide and 300-500 ml water 30 minutes before examination. Ultrasonography was performed, later analyzed with the results of fluoroscopy, lithotripter treatment and operation. Results 368 cases with uretal calculi were confirmed by fluoroscopy, lithotripsy or operation. The relationship between the calculi positioning at the ureter crossing main iliac artery was obvious. CDFI could find turbulent color flow signal around the calculi. Conclusion The calculi at the second narrowing of ureter can be positioned exactly by iliac artery. CDFI was useful in detection of non-obstructing calculi in along the ureter. Therefore, the coordinated 2DUS and CDFI could not only detect the calculi at every section of ureter, but also find the calculi at the second narrowing or the non-obstructing ones.