Objective To observe the imaging findings of congenital megaureter in order to enhance the understanding of this disease. Methods Image data of 5 patients with congenital megaureter and 2 misdiagnosed patients were a...Objective To observe the imaging findings of congenital megaureter in order to enhance the understanding of this disease. Methods Image data of 5 patients with congenital megaureter and 2 misdiagnosed patients were analyzed, and image findings of congenital megaureter were summarized. Elscint Prestig 2.0T superconductive magnetic resonance urography （MRLI） with conventional sequence （spin-echo, T 1W1560 ms/16 ms; fast spin-echo, T2WI 9600 ms/96 ms） was performed. Raw data were acquired with fast spin-echo sequence from heavy T2-weighted image （9600 ms/120 ms）. Post-processing method of MRH was the maximum in- tensity projection with three-dimensional reconstruction in the workstation. Intravenous pyelography （IVP） was conducted, in which X-ray films were taken 7 minutes, 15 minutes, and 30 minutes after injecting contrast agent, except that in 2 patients the films were taken delayed at 60 and 90 minutes. X-ray retrograde pyelography was performed on 2 patients, successful in one but failed in the other. Results The dilated ureter showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images in conventional MRI. The mass wall was intact, uniform in thickness, and showing hy- pointensity on Tl-weighted and T2-weighted images. The MRH images showed a retroperitoneal mass appearing as an elongated tubular cystic structure spreading from kidney to bladder. MRLI also revealed dilated calices and renal pelvis, pelviureteric obstruction, and renal duplication. The main signs of congenital megaureter in X-urography was significant dilatation of ureter, or normal renal pelvis with ureter dilatation, hydronephrosis, deformity, and displacement. Conclusions MRH with X-urography could visualize the characteristics of congenital megaureter, including the dilation of renal pelvis and ureter, calculi, urinary tract duplication, and stenosis location. The two techniques can complement each other in disease diagnosis and provide more detailed information for preoperative treatment.展开更多
文摘1病例资料
患者男性,55岁,因间断胸闷、胸痛,伴气短1年,加重5d于2015年10月29日入住我科.患者于1年前运动后出现胸闷、胸痛,伴气短、汗出,伴左侧肩背部酸胀感,无恶心、呕吐、发热、咳嗽等,休息3～5 min后症状好转,未予重视,此后症状间断发作.5d前患者于活动后再次出现上述症状,休息约5 min可缓解.为求进一步诊治就诊于我院门诊.行运动试验示：阳性,Ⅱ、Ⅲ、AVF、V4～V6导联ST段运动中、后动态改变（Ⅱ、Ⅲ、AVF导联ST段压低0.20～0.25 mV,V4～V6导联ST压低0.1～0.2 mV）,门诊以“冠状动脉粥样硬化性心脏病、不稳定型心绞痛”收入我科.患高血压15年,血压最高160/100 mm Hg（1 mm Hg=0.133 kPa）,平日口服尼群地平10 mg,2次/d,血压波动在130～140/80～90 mm Hg,否认糖尿病病史,脑梗死病史5年,有磺胺类药物过敏史,吸烟史20余年,每日30支左右,已戒烟10余年,饮酒史40余年,平均每天100 ml.
文摘Objective To observe the imaging findings of congenital megaureter in order to enhance the understanding of this disease. Methods Image data of 5 patients with congenital megaureter and 2 misdiagnosed patients were analyzed, and image findings of congenital megaureter were summarized. Elscint Prestig 2.0T superconductive magnetic resonance urography （MRLI） with conventional sequence （spin-echo, T 1W1560 ms/16 ms; fast spin-echo, T2WI 9600 ms/96 ms） was performed. Raw data were acquired with fast spin-echo sequence from heavy T2-weighted image （9600 ms/120 ms）. Post-processing method of MRH was the maximum in- tensity projection with three-dimensional reconstruction in the workstation. Intravenous pyelography （IVP） was conducted, in which X-ray films were taken 7 minutes, 15 minutes, and 30 minutes after injecting contrast agent, except that in 2 patients the films were taken delayed at 60 and 90 minutes. X-ray retrograde pyelography was performed on 2 patients, successful in one but failed in the other. Results The dilated ureter showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images in conventional MRI. The mass wall was intact, uniform in thickness, and showing hy- pointensity on Tl-weighted and T2-weighted images. The MRH images showed a retroperitoneal mass appearing as an elongated tubular cystic structure spreading from kidney to bladder. MRLI also revealed dilated calices and renal pelvis, pelviureteric obstruction, and renal duplication. The main signs of congenital megaureter in X-urography was significant dilatation of ureter, or normal renal pelvis with ureter dilatation, hydronephrosis, deformity, and displacement. Conclusions MRH with X-urography could visualize the characteristics of congenital megaureter, including the dilation of renal pelvis and ureter, calculi, urinary tract duplication, and stenosis location. The two techniques can complement each other in disease diagnosis and provide more detailed information for preoperative treatment.
