Role of Plain Abdominal X-Ray in the Differential Diagnosis of Common Acute Abdominal Conditions in Children at Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria

Background: The plain abdominal x-ray is one of the commonly requested investigations in the children emergency room, paediatric surgical ward and neonatal wards. The short interval required to carry out this investigative procedure and obtain results makes it the first imaging modality used to unravel the different causes of acute abdominal conditions in children. The safety of abdominal x-ray in children makes it attractive for use in paediatric surgical practice as part of routine work-up for undifferentiated acute abdominal conditions and also to diagnose specific causes of acute abdomen in children. Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State. Objectives: Evaluation of the role of plain abdominal x-ray in diagnosing common acute abdominal conditions in children. Materials and method: Patients admitted to the children emergency room, paediatric surgical wards, children’s ward and neonatal ward who had plain abdominal x-ray as part of their diagnostic work-up were included in the study. They were studied prospectively between March 2011 and April 2021. Results: Three Hundred and Ninety-nine patients who had plain abdominal x-rays as part of their diagnostic work-up were studied. Males were 240 while females were 159, a male to female ratio of 1.5:1. The patients were aged between 1 day to 16 years. Differential diagnoses made with plain abdominal x-ray were intestinal obstruction in 298, perforated viscus 69 patients, intra-abdominal masses 13 patients and location of intra-abdominal foreign body 14. Intestinal obstruction cases in which plain abdominal x-ray played a role in their diagnosis and management included the following: intussusception 66, neonatal sepsis 60, malrotation 48, intestinal atresia 42, anorectal malformation 32, hirschsprung’s disease in 30 cases, pyloric stenosis 24, obstructed hernia 22, post-operative adhesions 16 and intestinal helminthiasis 12. Perforated viscus accounted for 69 indications. Out of these indications, perforated gut in intussusception 19, perforated typhoid ileitis was responsible in 13 cases, gut perforation in blunt abdominal trauma 8, perforation in strangulated hernia 11 cases, perforated gut in malrotation 7, ceacal perforation in hirschsprugs disease 6 and colonic perforation in necrotizing enterocolitis 5 cases. Conclusion: Plain abdominal x-ray remains a role to play in the differential diagnosis and management of common paediatric acute abdominal conditions.

Role of contrast-enhanced serial/spot abdominal X-rays in perioperative follow-up of patients undergoing abdominal surgery:An observational clinical study

BACKGROUND Many imaging methods such as ultrasonography,computed tomography(CT),magnetic resonance imaging,and endoscopy are used to identify the problems or complications that occur in the perioperative period and to determine the appropriate therapeutic approach.Specialists at surgical clinics and intensive care units sometimes need diagnostic procedures that can give quick results or reveal unexpected results.In particular,rapid on-site evaluation of patients followed under intensive care conditions has several advantages.AIM To determine the problems developing in patients in the perioperative period by contrast-enhanced abdominal X-ray(CE-AXR),revealing their current status or defining the effectiveness of CE-AXR.METHODS The files of the patients who underwent hepatopancreatobiliary or upper gastrointestinal surgery,whose CE-AXR film was taken,were reviewed retrospectively.Abdominal X-ray radiographs taken after ingestion of a watersoluble contrast agent(iohexol,300 mg,50 cc vial)and its application in a drain,nasogastric tube,or stent were evaluated.The contribution of the data obtained in patients who underwent CE-AXR to the diagnosis,follow-up,and treatment processes and the effectiveness of the application were investigated.RESULTS CE-AXR was applied to 131 patients in our clinic,most of whom underwent hepatopancreatobiliary or upper gastrointestinal surgery.It was determined that the data obtained from CE-AXR films taken in 98(74.8%)of the patients contributed to the diagnosis,treatment,and follow-up expectations and positively affected the clinical processes.CONCLUSION CE-AXR is a simple procedure that can be applied anywhere,especially in intensive care patients and at bedside,with a portable X-ray device.The simplicity of the procedure,less radiation exposure for the patients,less time wastage,reduction in the CT and endoscopy procedure burden and costs,quick results,rapid assessment of the situation,and enabling the monitoring of processes with repetitive procedures are important advantages.X-rays taken will be useful in terms of being a reference value during the follow-up period of the patient and determining the situation in medicolegal processes.

Development of the Press-Through Package Recognizable with Abdominal X-Ray Image of Abdominal Soft Tissue Phantom

Background: Patients with dementia who accidentally swallowed a press- through package (PTP) have been increased in recent years. Swallowed PTP is usually detected with CT having a risk of radiation exposure since PTP is very difficult to detect with abdominal X-ray image. Purpose: This study is aimed at developing the new PTP sheet recognizable with abdominal X-ray by improving the conventional PTP sheet. Material and Methods: The PTP sheet samples used in this study are: No. 1 Control: Commercially available tablet 100 mg, No. 2 Triple-stacked aluminum foil, 6-overcoated with BaSO4 10.3 g/m2, No. 3 Aluminum foil, 6-overcoated with BaSO4 10.3 g/m2, No. 4 Five-stacked aluminum foil, 6-overcoated with BaSO4 No. 5 Aluminum foil, single-coated with WO3 2.55 g/m2, No. 6 Aluminum foil, double-coated with WO3 5.1 g/m2, No. 7 Aluminum foil, triple-coated with WO3 7.66 g/m2, No. 8 Three-stacked aluminum foil, triple-coated with WO3. PTP sheets (No. 1 - No. 8) were placed inside the abdominal soft tissue phantom, and the images were obtained using FUJIFILM DR CALNEO PT. Region of interest (ROI) was placed on PTP sheets (No. 1 - No. 8) and abdominal soft tissue liquid phantom, and each contrast was measured from the average pixel of the two ROIs. Contrast was calculated by the calculation formula. Each ROI was measured three times, and their average value and standard deviation were estimated. Results: Statistical significance in contrast was not observed in commercial PTP sheet (No. 1), PTP sheet (No. 3), and PTP sheet (No. 5), while there was a significant difference between PTP sheet (No. 1) and PTP sheet (No. 2), PTP sheet (No. 4) PTP sheet (No. 6), PTP sheet (No. 7) (p Conclusion: The other all prototype PTP sheets (No. 2, No. 4, No. 6, No. 7 and No. 8) were well recognized. PTP sheets (No. 2, No. 4) of BaSO4 is considered to be more suitable than PTP sheets of WO3 (No. 6, No. 7, No. 8) because it is easier to produce. We will develop oral PTP sheets for patients with dementia for abdominal X-ray in the future.

Correlation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast enhanced imagesCorrelation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast enhance

Objective:To investigate the correlation of abdominal aorta CT value,renal artery CT value and renal cortex thickness with renal cortex CT value on contrast enhanced 64-slice CT images.Methods:96patients(50 men and 46women;16~74years)with normal kidney function,which was confirmed by kidney function test were enrolled in this study,including bilateral kidneys of 92cases and unilateral kidney of 4cases(total of 188kidneys;92left,96right).After intravenous(IV)injection of contrast agent the kidneys of the selected patients were scanned by MDCT.The scans were performed in arterial,venous and 3min delayed phases.All statistical analyses were performed by using IBM SPSS 20.0.Graphs were generated using Graph Pad Prism 5software.Quantitative data were presented as mean±standard deviation,while qualitative data were presented as frequency(%).P<0.05was considered to be statistically significant.Results:The mean renal cortex thickness was(5.19±0.81)mm in all kidneys.In the arterial phase,a statistically significant positive correlation between renal cortex CT values and abdominal aortic CT values was showed(r=0.584;P<0.001).A statistically significant positive correlation between renal cortex CT values and renal cortex thickness was demonstrated(r=0.533,P<0.0001).Likewise,there was a positive correlation between renal cortex CT value and renal artery CT values(r=0.43,P<0.001).Conclusion:It is a promising approach to assess the individual kidney function by measuring abdominal aorta CT value,renal artery CT value,renal cortex CT value and renal cortex thickness using contrast MDCT.

Reduction of the Radiation Dose by Decreasing the Tube Current without Degradation of Low-Contrast Detectability on Abdominal Multi-Detector Row CT: A Phantom-Based Study

As use of the lowest acceptable radiation dose during routine diagnostic imaging is important, we determined the optimal tube current without degradation of low-contrast detectability on abdominal multi-detector row CT (MDCT). CT scanning was performed with a Catphan&#174;?500 phantom. The optimal tube current was 300 mA on 64-MDCT and 160 mA on 8-MDCT, with a fixed voltage of 120 kV. Reduction of the radiation dose in abdominal CT scanning by lowering the tube current proved to be feasible.

Volvulus of the ascending colon in a non-rotated midgut:Plain film and MDCT findings

Colonic volvulus is a relatively uncommon cause of large bowel obstruction usually involving mobile,intraperitoneal,colonic segments.Congenital or acquired anatomic variation may be associated with an increased risk of colonic volvulus which can occasionally involve retro-peritoneal segments.We report a case of 54-year-old female who presented to our Institution to perform a plain abdominal film series for acute onset of cramping abdominal pain.Both the upright and supine films showed signs of acute colonic obstruction which was thought to be due to an internal hernia of the transverse colon into the lesser sac.The patient was therefore submitted to a multi-detector contrast-enhanced computed tomography(CT).CT findings were initially thought to be consistent with the presumed diagnosis of internal hernia but further evaluation and coronal reformatting clearly depicted the presence of a colonic volvulus possibly resulting from a retro-gastric colon.At surgery,a volvulus of the ascending colon was found and a right hemi-colectomy had to be performed.However,a non rotated midgut with a right-sided duodeno-jejunal flexure and a left sided colon was also found at laparotomy and over-looked in the pre-operative CT.Retrospective evaluation of CT images was therefore performed and a number of CT signs of intestinal malrotation could be identified.

Application of molybdenum target X-ray photography in imaging analysis of caudal intervertebral disc degeneration in rats

BACKGROUND Conventional plain X-ray images of rats,the most common animals used as degeneration models,exhibit unclear vertebral structure and blurry intervertebral disc spaces due to their small size,slender vertebral bodies.AIM To apply molybdenum target X-ray photography in the evaluation of caudal intervertebral disc(IVD)degeneration in rat models.METHODS Two types of rat caudal IVD degeneration models(needle-punctured model and endplate-destructed model)were established,and their effectiveness was verified using nuclear magnetic resonance imaging.Molybdenum target inspection and routine plain X-ray were then performed on these models.Additionally,four observers were assigned to measure the intervertebral height of degenerated segments on molybdenum target plain X-ray images and routine plain X-ray images,respectively.The degeneration was evaluated and statistical analysis was subsequently conducted.RESULTS Nine rats in the needle-punctured model and 10 rats in the endplate-destructed model were effective.Compared with routine plain X-ray images,molybdenum target plain X-ray images showed higher clarity,stronger contrast,as well as clearer and more accurate structural development.The McNemar test confirmed that the difference was statistically significant(P=0.031).In the two models,the reliability of the intervertebral height measured by the four observers on routine plain X-ray images was poor(ICC<0.4),while the data obtained from the molybdenum target plain X-ray images were more reliable.CONCLUSIONMolybdenum target inspection can obtain clearer images and display fine calcification in the imaging evaluation of caudal IVD degeneration in rats,thus ensuring a more accurate evaluation of degeneration.

比较腹盆腔增强CT、盆腔MRI平扫在正确预测淋巴结状态方面的诊断性能

目的探讨在卵巢癌淋巴结转移诊断中,腹盆腔增强CT与盆腔MRI平扫的诊断性能对比。方法选取卵巢癌患者46例作为研究对象,安排接受腹盆腔增强CT与盆腔MRI平扫,以病理结果为参照计算两种方法的灵敏度、特异度、阳性预测值以及阴性预测值。结果CT扫描检查结果显示,腹盆腔增强CT在卵巢癌盆腔淋巴结转移诊断中,灵敏度为45.00%,特异度为73.08%;盆腔MRI平扫在卵巢癌盆腔淋巴结转移诊断中,灵敏度为60.00%,特异度为80.77%;腹盆腔增强CT联合盆腔MRI平扫在卵巢癌盆腔淋巴结转移诊断中,灵敏度为85.00%,特异度为92.31%。结论在卵巢癌淋巴结转移诊断中,相较于腹盆腔增强CT,盆腔MRI具有较高的诊断灵敏度和特异度,但两者联合运用取得的诊断效能更高。

Clues for diagnosing misplaced central venous catheter in the right ascending lumbar vein during right femoral venous access

The right ascending lumbar vein is difficult to detect on anteroposterior abdominalradiographs because it overlaps with the inferior vena cava on anteroposteriorradiographs.Intensive observation by medical providers may be a cue fordiagnosis.However,knowledge of catheter misplacement of the right ascendinglumbar vein is also necessary,because misplacement cannot be suspected withoutthat awareness.

CT对腹盆部外伤患者的临床诊断价值分析

目的:研究CT诊断应用于腹盆部外伤患者中的价值。方法:选取2023年4—9月东莞市横沥医院收治的100例腹盆部外伤患者作为研究对象,均实施X线平片诊断、CT诊断,分别记作基础诊断组、特殊诊断组,以手术病理结果作为“金标准”,统计两种诊断方式的应用价值。结果:手术病理结果显示,60例患者属于单纯性病症,其中脾破裂15例,肝破裂13例,肾脏损伤10例,肠损伤10例,胰腺损伤5例,膀胱损伤7例。40例患者属于复合性病症,其中肝脏与脾胃合并损伤8例,脾胃与肾脏合并损伤10例,胰腺与脾胃合并损伤4例,肝脏与膈肌合并损伤6例,小肠与肠系膜合并损伤5例,肝脏、脾胃、肾脏合并损伤7例。两组各单纯性和复合性病症诊断准确率比较,差异无统计学意义(P>0.05)。特殊诊断组检验便捷性、检验经济性、检验科学性、检验全面性、检验精准性评分高于基础诊断组(P<0.05)。结论:CT诊断对腹盆部外伤患者的临床诊断价值较高,得到了临床医师的肯定。

腹部X线平片检查与超声检查对儿童急性肠梗阻诊断效能的对比分析

目的:分析超声检查与腹部X线平片在儿童急性肠梗阻临床诊断中的效能。方法:选取2022年1月至2023年11月期间本院急诊科收治的74例急性肠梗阻患儿作为研究对象。患儿急诊入院后均分别接受超声检查、腹部X线平片检查。以临床综合诊断结果作为“金标准”,观察对比超声、腹部X线平片影像学表现。分析对比两种检查对急性肠梗阻的诊断效果。结果:经过临床综合诊断,本研究的74例患者中,梗阻部位:小肠梗阻41例,结肠梗阻33例;出现肠绞窄者17例。肠梗阻的病因:肠粘连30例,疝7例,肠套叠15例,粪石17例,肠扭转5例。腹部X线平片检出梗阻部位的总符合率高于超声检查,但无显著差异(P>0.05)。腹部X线平片对肠绞窄的检出率比超声检查显著降低(P<0.05)。超声检查对肠梗阻病因总诊断符合率为70.27%(52/74),比腹部X线平片显著提高(P<0.05)。结论:超声检查对儿童急性肠梗阻病因、肠绞窄的检出效果相对优于腹部X线平片,可为临床诊治儿童急性肠梗阻提供更全面的影像学信息。

两种不同影像学检查方式在急性肠梗阻诊断中的比较分析

目的 探究急性肠梗阻应用腹部X线平片与多层螺旋电子计算机断层扫描(CT)的诊断价值。方法 选取2021年10月—2022年10月本院收治的80例疑似急性肠梗阻患者的临床资料进行回顾性分析,所有的患者均行腹部X线平片、多层螺旋CT检查及病理组织活检,以病理学结果作为金标准。比较腹部X线平片与多层螺旋CT检查对急性肠梗阻的检出结果、符合率及诊断效能;并对其中的典型病例进行分析。结果 80例疑似急性肠梗阻患者中阳性为62例,阴性为18例;经腹部X线平片检查真阳性为29例,真阴性为7例,假阳性11例,假阴性33例;经多层螺旋CT检查真阳性为53例,真阴性为16,假阳性2例,假阴性9例;多层螺旋CT检查的符合率、特异度、灵敏度、准确度、阳性预测值、阴性预测值均高于腹部X线平片,组间比较差异显著有统计学意义(P<0.05)。结论 与腹部X线平片检查相比,在急性肠梗阻患者中应用多层螺旋CT检查的符合率、特异度、灵敏度、准确度、阳性预测值、阴性预测值均较高,有利于临床对急性肠梗阻患者进行及时、准确的诊断,并实施有效的针对性治疗及干预,进而改善患者预后。

Diagnostic significance of ultrasonography and CT for large upper abdominal mass

OBJECTIVE: To assess the effect of ultrasonography and computerized tomography (CT) in the diagnosis of large upper abdominal mass. METHODS: Data from 43 cases that were clinically and pathologically confirmed were retrospectively analyzed and the effect of their preoperative ultrasonography and CT was compared. RESULTS: Four of 10 (40 percent) cases of liver mass were diagnosed correctly using ultrasonic device, nineteen of 25 (76 percent) cases of adrenal gland mass and 2 of 4 cases of kidney mass. Two of 10 (20 percent) cases of liver mass were correctly diagnosed by CT, and so were 6 of 22 (27.2 percent) cases of adrenal gland mass. In 4 patients with spleen mass, neither ultrasonography nor CT diagnosis was correct. CONCLUSION: Because upper abdomen organs are closely connected with each other, correct imaging localization of a large mass in this region is not easy. In this study, we compared the accuracy of ultrasonography and CT in diagnosing large upper abdominal masses, and found that ultrasonography works better for adrenal rather than liver or kidney. Neither ultrasonography or CT could accurately diagnose a large mass in the spleen.

X线数字断层融合技术在腹部平片和静脉肾盂造影中的应用价值

目的通过与数字摄片比较,探讨X线数字断层融合技术在腹部平片和静脉肾盂造影中的应用价值。方法在大平板多功能数字化透视摄影系统Sonialvision SatireⅡ下进行腹部平片和静脉肾盂造影检查,选择时机应用数字断层融合技术,经计算机后处理获取高清晰的图像。结果 178个病例中,经临床证实异常者157例。(157/178):泌尿系统结石95例(95/178),其中肾结石50例,输尿管结石13例,膀胱结石5例,多器官结石27例;不明原因肾积水16例,(16/178);肾囊肿16例(16/178);肾旋转不良10例(10/178);异位肾2例(2/178);腹膜后肿瘤压迫3例(3/178);肾癌2例(2/178);肾结核2例(2/178)。结论在静脉肾盂造影过程中,适时应用数字断层融合技术,能够消除重叠伪影的干扰从而获得高清晰、高对比度、高质量的图像,清晰显示肾盂肾盏的解剖结构和病变形态。

超声和腹部X射线平片在诊断儿童急性肠梗阻中的价值比较

目的:比较超声和腹部X线平片对于诊断儿童急性肠梗阻的实用价值进行分析,以便根据临床实际情况选择合适的检查方法。方法:选取收入我院的120例患有急性肠梗阻的儿童,均在进行手术前行超声检查和腹部X线平片检查,对手术结果进行分析,讨论这两种检查方法对于临床疾病的诊断准确性。结果:超声的确诊率为97%,腹部X线平片的确诊率为85%,腹部X线平片检查明显低于超声检查,对两种方法进行比较,具有统计学的意义(P<0.01),超声对于儿童急性肠梗阻的确诊率明显高于腹部X线平片的确诊率。结论:传统腹部平片诊断儿童急性肠梗阻的敏感性和特异性较低,而超声确诊儿童急性肠梗阻的正确率接近于100%,与X线等其他检查相比超声对于梗阻的原因诊断准确性也极高,是否发生绞窄性肠梗阻超声检查比X线平片显示更有价值。

多层螺旋CT平扫对急性腹部创伤的诊断价值

目的:进一步认识16层螺旋CT平扫在急性腹部创伤中的诊断价值。方法:990例急性腹部创伤患者,在未口服对比剂情况下行16层螺旋CT平扫,分析其CT影像表现。CT扫描后123例行剖腹术,18例经介入治疗,665例经过1次以上CT随访。把CT初诊结果与手术及随访结果进行比较,观察CT平扫发现急性腹部创伤的敏感性、特异性。结果:990例腹部创伤患者中,首诊阴性病例703例,阳性病例287例,其中实质性脏器损伤238例,空腔脏器损伤7例,实质性脏器损伤合并空腔脏器损伤19例,23例仅见腹腔积液。与手术及随访结果比较,发现实质脏器损伤的假阳性9例,假阴性2例;空腔脏器损伤的假阳性3例,假阴性5例。实质性脏器损伤的敏感性为99.2%,特异性为98.8%;空腔脏器损伤的敏感性为82.1%,特异性99.7%。结论:多层螺旋CT对急性腹部创伤有较高诊断价值,对实质性脏器损伤的发现具有很高的敏感性、特异性,对于空腔脏器损伤诊断的敏感性相对较低。

X线数字断层融合技术对单纯性肾囊肿的诊断价值

讨论通过与数字摄片比较,探讨X线数字断层融合技术对单纯性肾囊肿的诊断价值。在大平板多功能数字化透视摄影系统Sonialvision SatireⅡ下进行腹部平片和静脉肾盂造影检查,同时应用数字断层融合技术,经计算机后处理获取高清晰的肾盂、肾盏及肾囊肿图像。结果46例单纯性肾囊肿中,确诊39例(占84.8%),均为肾单个囊肿:其中右肾囊肿15例,左肾囊肿21例,双肾囊肿3例;囊肿最大径从3.3cm～6.8cm不等。因此在静脉肾盂造影过程中,适时应用数字断层融合技术,能够消除重叠伪影的干扰,清晰显示肾囊肿的境界、大小、形态、密度。

腹部CT平扫在急性胰腺炎诊断和预后预测中的应用

研究腹部CT平扫在急性胰腺炎诊断中的应用及对预后预测的价值。回顾性分析164例急性胰腺炎患者临床资料,分析急性胰腺炎腹部CT影像学特征;根据并发症及死亡作为判断预后标准。采用Logistic回归分析法明确影响急性胰腺炎患者发生并发症及死亡的危险因素。采用Bahhazar-CTSI评分系统对患者病情进行分级,比较不同CTSI评分患者的并发症发生率及死亡率情况;观察急性胰腺炎患者病情严重程度与并发症及死亡的关系。在164例急性胰腺炎患者并发症发生率为51.83%,死亡率为7.32%。急性胰腺炎患者发生并发症及死亡与脂肪肝、胃裸区受侵、肾上腺受侵、肝上间隙积液以及肾周围间隙受侵有关(P<0.05)。重度脂肪肝、胃裸区受侵、肾上腺受侵、肝上间隙积液以及肾周围间隙受侵均是影响急性胰腺炎患者发生并发症的危险因素(P<0.05),胃裸区受侵、肾上腺受侵、肝上间隙积液均是影响急性胰腺炎患者发生死亡的危险因素(P<0.05)。Bahhazar-CTSI评分与急性胰腺炎患者并发症发生率、死亡率呈正相关(r=0.657、0.688,P<0.05)。急性胰腺炎腹部CT影像学具有征象特征性,可明确显示胰腺病变程度及周围组织器官累及情况,对急性胰腺炎的诊断与预后有较高的预测价值。

腹部平片清洁灌肠方法的改进

目的探讨改良清洁灌肠方法用于腹部平片检查患者的临床效果,以提高清洁灌肠的效果。方法采用单盲法将140例疑为泌尿系结石需行腹部平片或静脉肾盂造影患者随机分成两组各70例。对照组采用传统清洁灌肠方法,观察组采用改良清洁灌肠方法,即采用右侧屈膝卧位,冲洗袋高度距肛门60～100 cm,置入肛管长度20～25 cm;评价灌肠效果、灌肠效率及患者主观感受与不良反应。结果与对照组比较,观察组X线显影清晰度显著提高,灌肠总次数减少(均P<0.01);在患者主观感受与不良反应方面,心慌气短、肛门坠胀感、灌肠液外溢、肠黏膜损伤出血发生率显著减少(P<0.05,P<0.01)。结论改良清洁灌肠方法可有效地提高肠道清洁质量,使患者更安全、舒适。

髓质海绵肾的影像学表现

目的分析髓质海绵肾(MSK)的影像学表现,以期提高对该病诊断的正确性。方法回顾性分析8例MSK在腹部X线平片I、VP、CT及MRI上的影像表现,并进行文献复习。结果 8例中累及右肾4例,左肾2例,双侧肾2例。腹部X线平片5例见肾内多发小结石呈散在或簇状排列,3例未见异常。静脉肾盂造影6例肾功能正常,肾盏外围扩张的集合管内见造影剂充盈,使肾锥体呈花蕾状或葡萄串状致密影,结石位于扩张的集合管内;2例肾盂肾盏扩张,造影剂显影延迟。CT检查可以发现腹部X线平片未能显示的细小结石,增强扫描见肾锥体呈条纹状或小囊状扩张。MRI检查见肾锥体内结石在T1WI及T2WI均呈低信号,T2WI及MRU成像肾锥体内可见条纹状、放射状及小囊状高信号影,大小不等。结论 MSK有其特征性影像表现I,VP、CT、MRI都有助于MSK的诊断,但以IVP检查为首选。