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目的 提高对先天性巨输尿管症的认识和诊断。方法 作者总结了 2 8例经尿路造影、B超、利尿性肾图等多种影像检查及手术病理证实的先天性巨输尿管症的静脉尿路造影及B超声像图表现。结果 本症以输尿管近膀胱段短于 3cm保持正常管径的无动力非梗阻性狭窄 ,狭窄段以上输尿管继发性显著扩张为特征 ,扩张可延及肾盂肾盏。尿路造影、B超表现为患侧输尿管明显扩张 ,以中下段为著 ,可延及全程。狭窄段以上扩张的输尿管可呈杵状、蛇头状、纺锤状或鼠尾状。透视或B超适时观察见巨输尿管蠕动频率减低 ,蠕动幅度增大 ,向下传递间断。结论 静脉尿路造影为诊断本病的主要方法 ,B超、逆行尿路造影及膀胱镜为必要的辅助检查方法。
Objective To improve understanding and diagnosis of congenital giant ureter. Methods The authors summarized 28 cases of congenital megacoureter confirmed by urethral angiography, B-mode ultrasonography, diuretic nephrogram, and other pathological findings of venous urography and B ultrasound imaging. Results of this disease in the proximal ureter to retain normal diameter less than 3cm diameter non-obstructive stenosis, ureteral secondary stricture above the significant expansion of the expansion can be extended to the renal pelvis calyx. Urography, B-ultrasound showed significant expansion of the ipsilateral ureter, with the middle and lower sections as a continuation of the entire process. Ureteral expansion of the narrow section may be clubbing, snake head, spindle or rat caudate. See fluoroscopy or B-timely observation of the giant ureter peristalsis frequency decreased, increased creep amplitude, downward transmission intermittent. Conclusion Intravenous urography is the main method to diagnose this disease. B-mode ultrasonography, retrograde urography and cystoscopy are the necessary auxiliary examinations.