磁共振尿路成像对肾盂输尿管先天性疾病的诊断价值

目的：探讨磁共振尿路成像(MRU)对肾盂、输尿管先天性疾病的诊断价值。方法：对11例肾盂、输尿管先天性疾病患者行MRU检查以明确诊断。结果：MRU诊断肾盂输尿管交界处狭窄3例，腔静脉后输尿管3例．巨输尿管症2例，肾盂输尿管完全重复畸形伴异位开口3例；均可显示梗阻部位及尿路扩张的形态，其定位诊断准确率为100％。结论：MRU是安全有效的非侵袭性的影像学检查方法，对肾盂、输尿管先天性疾病患者，尤其对有静脉尿路造影禁忌证和患侧肾功能严重受损的患者，具有特殊诊断价值。     

磁共振尿路成像在尿路梗阻诊断中的价值

目的：评价磁共振尿路成像（Magnetic resonance urography,MRU)对尿路梗阻的诊断价值。方法：对106例疑有尿路梗阻的患者进行MRU检查,并结合临床手术病理资料和其他影像资料进行回顾性分析。结果：106例患者中,103例获得MRU阳性结果,定位诊断准确;在定性诊断方面,对肾盂输尿管连接处梗阻的诊断有明显帮助。对31例输尿管结石和20例输尿管癌及息肉患者,MRU明确诊断都分别为3例和7例。结论：MRU对尿路梗阻的定位诊断具有很高的价值。而在定性诊断方面具有一定的局限性。     

磁共振水成像与逆行肾盂造影检查对输尿管梗阻性病变的诊断价值

目的:比较磁共振输尿管水成像(MRU)和逆行肾盂造影(RP)检查对输尿管梗阻性疾病的诊断价值。方法:回顾分析20例输尿管梗阻性病变患者进行MRU和RP检查,并经病理证实,对两者进行对照分析。结果:20例输尿管梗阻中输尿管结石9例,先天性狭窄5例,输尿管炎性狭窄3例,输尿管肿瘤2例,输尿管内血凝块1例,MRU与RP均能清晰显示输尿管的梗阻部位,定位诊断准确率相似,定性诊断MRU明显高于RP。结论:MRU对输尿管梗阻性病变的定位、定性诊断准确率高,且具有无创伤、无痛苦、无辐射、不需造影剂及三维成像等特点,可以替代大多数RP检查,尤其是对儿童及不能耐受RP检查患者应为首选的检查方法。     

磁共振尿路成像对泌尿系疾病的诊断价值

目的评价磁共振尿路成像(Magneticresonanceurography,MRU)对泌尿系疾病的诊断价值。方法对36例泌尿系疾病患者进行MRU检查,并结合临床手术、病理资料和其他影像学资料进行回顾性分析。结果36例患者中,均有MRU阳性结果,3例肾盂、肾盏癌,4例前列腺癌,8例前列腺增生症,2例输尿管癌定性、定位明确;9例肾盂、输尿管移行段梗阻定位明确,定性有帮助;10例输尿管下段梗阻中6例诊断明确,4例未能确诊。结论MRU在泌尿系疾病的诊断中,对肿瘤的定位、定性参考价值较高,对尿路梗阻定位诊断有价值,对定性诊断帮助有其局限性。     

评价磁共振水成像技术对移植肾输尿管梗阻的诊断价值

目的 评价磁共振水成像（MRU）技术对移植肾输尿管梗阻的诊断价值。方法 采用MRU技术对11例B型超声波定性诊断为移植肾积水的患者进行移植肾输尿管至膀胱的磁共振扫描，按最大强度投影法重建出MRU图像。结果 11例MRU均能清晰显示移植肾输尿管梗阻的部位及积水情况，解剖结构清楚，5例显示移植肾输尿管下段-膀胱吻合口狭窄，3例为移植肾肾盂输尿管连接处狭窄，3例为移植肾肾盂、输尿管结石梗阻。结论 MRU是无创伤的检查方法，无须应用碘造影剂，对人和移植肾无损害，对梗阻性疾病定位准确，尤其适用于移植肾泌尿系统梗阻的诊断。     

MR尿路造影在泌尿外科疾病诊断中的应用

自１９９６年１１月～１９９７年５月采用ＭＲ尿路造影（ＭＲＵ）诊断泌尿外科疾病患者２２例，其中尿路无病变６例，上尿路梗阻６例，输尿管癌２例，肾输尿管结核１例，输尿管结石４例，神经性膀胱所致慢性肾功能衰竭１例，膀胱癌２例。结果：尿路无病变６例ＭＲＵ均能明确显示尿路无梗阻；６例上尿路梗阻可明确病变；４例尿路结石单纯ＭＲＵ无法诊断病变；２例输尿管癌ＭＲＵ不能显示输尿管下段与膀胱重叠部位病变；１例肾输尿管结核ＭＲＵ有典型征象；１例慢性肾功能衰竭，ＭＲＵ清晰显示尿路扩张、积水；２例膀胱癌ＭＲＵ清晰显示膀胱占位及膀胱壁浸润。结果认为：ＭＲＵ是一种新的、无创性、无需造影剂诊断尿路病变的方法     

原发性输尿管癌的磁共振诊断

目的分析输尿管癌的磁共振成像（MRI）表现，评价MRI对原发性输尿管癌的诊断价值。方珐用1．5T磁共振扫描仪，采用T2加权成像（T2WI）快速自旋回波序列（FSE）、脂肪抑制技术和MR尿路造影（MRU）检查，观察分析21例原发性输尿管癌的MRI表现。结果21例原发性输尿管癌中，5例表现为输尿管上端结节状病灶，4例表现为输尿管中段结节或条状病灶，12例表现为输尿管下段或下端结节或条状病灶。T1WI为等、略低信号，T2WI为等、高信号，增强扫描有轻、中度强化。MRU显示输尿管截然中断13例，鼠尾状狭窄中断4例，管壁不规则狭窄僵硬4例，与术中所见梗阻部位及程度完全相符。结论MRI结合MRU能清晰显示输尿管肿瘤的梗阻部位、梗阻程度以及累及范围、周围结构情况，选择合理的检查序列加做增强扫描，是诊断输尿管肿瘤的理想方法。     

磁共振水成像对输尿管肿瘤的诊断价值

目的:探讨磁共振水成像技术(MRU)在原发性输尿管肿瘤的诊断价值。方法:对27例原发性输尿管肿瘤的影像学资料并基于术中所见和病理报告,将MRU与超声?KUB IVU?逆行造影?CT的确诊率进行比较。结果:MRU能清晰显示输尿管的梗阻部位,定位诊断准确率100%,梗阻病因确诊率100%,优于B超、泌尿系造影?逆行造影和CT检查。结论:与其它影像诊断方法相比较,MRU在显示原发性输尿管肿瘤特征方面具有效率高、定位准确和安全无创等优点,而且有更广泛的临床应用范围。     

排泄性三维对比增强磁共振尿路造影联合MRU在上尿路结石诊断中的应用价值

目的：探讨排泄性三维对比增强磁共振尿路造影（3D-ceMRU）联合MRU在上尿路结石诊断中的价值。方法：对45例上尿路结石患者行MRU及3D-ceMRU扫描,与临床最终诊断对照后,比较3D-ceMRU联合MRU与IVU、BUS在上尿路结石诊断中的价值,评价3D-ceMRU及MRU对患侧上尿路的显影情况并做对比分析。结果：3D-ceMRU联合MRU诊断上尿路结石患者41例,诊断正确率为91．4％,定位诊断率为100％,与IVU和BUS相比,差异无统计学意义（P〉0．05）。正常和轻度积水的上尿路3D-ceMRU和图像质量优于MRU（P〈0．01）;而中一重度积水的上尿路MRU图像质量优于3D-ceMRU（P〈0．01）。结论：3D-ceMRU和MRU相结合能直观、清晰地显示结石的部位及上尿路形态,具有较高的定位、定性诊断准确性,是诊断上尿路结石的可靠方法。     

磁共振成像及其尿路造影对输尿管疾病的诊断价值

目的探讨磁共振成像（MRI）及磁共振尿路造影（MRU）对输尿管病变的诊断价值。方法对114例临床怀疑输尿管疾病的患者行磁共振成像（MRI）及磁共振尿路造影（MRU）检查,所有病例均经手术、病理或输尿管镜检证实。结果 114例输尿管疾病包括：先天性异常15例,良性狭窄21例,输尿管结石36例,输尿管癌18例,外在性病变24例。MRU对输尿管病变的定性诊断准确率为81.6%（93/114）;与常规MRI结合,定性诊断准确率提高到92.1%（105/114）。结论 MRU对输尿管病变的诊断具有良好的效果,特别适用于IVP禁忌证和肾功能丧失者;与常规MRI结合,可提高输尿管病变的定性诊断准确率。     

Ultrasonography for diagnosis of obstructing ureteral calculus

The reliability of ultrasonography in diagnosing ureteral obstruction caused by calculus was prospectively investigated. In 60 consecutive cases sonograms were compared with excretory urograms. The sonographic diagnosis was correct in 27 (79%) of the 34 cases shown by urography to have ureteral obstruction, and the sonograms showed the causal calculus in 17. The rate of false negative sonographic diagnosis was thus 21%. In two patients with no urographic abnormality, the sonograms indicated ureteral calculus without signs of obstruction. Ultrasonography may be used as an alternative to emergency urography for initial imaging in cases of suspected ureteral obstruction, but urography remains the standard method for evaluating the obstructed urinary tract, due to its greater accuracy and ability to assess renal function.     

尿路梗阻的磁共振尿路造影诊断

目的　探讨磁共振尿路造影（ ＭＲＵ） 对尿路梗阻性疾病的诊断意义。　方法　２１ 例尿路梗阻者接受检查,其中尿路中上段梗阻者１１ 例,盆段梗阻者７ 例,ＢＰＨ３ 例。　结果　梗阻端以上肾盂,输尿管或尿路全程积水扩张状态均在重Ｔ２ 成像显示。结石６ 例呈极低信号,上方有环状高信号带;肿瘤３ 例,软组织信号强度不等;良性狭窄１２ 例,其中肾盂、输尿管连接部梗阻３ 例、后腹膜纤维化１ 例及ＢＰＨ３ 例有典型表现;其他５ 例除显示梗阻程度与部位外,局部无特殊信号。　结论　ＭＲＵ 为一种非侵袭性,无需造影剂的新方法,对尿路梗阻的形态改变显示良好,无肾功能依赖性,尿路积水越重,图像越清晰。     

磁共振水成像对上尿路梗阻的诊断价值

目的:评价磁共振水成像(MRU)对泌尿系梗阻性疾病的临床诊断价值。方法:采用快速自旋回波重T2加权序列和脂肪抑制技术,对56例经B超和IVP怀疑上尿路梗阻患者,进行泌尿系冠状位扫描,将图像按最大强度投影法重建出MRU图像。结果:其中32例MRU均能清晰显示尿路梗阻的部位和肾盂积水,解剖结构清楚,可对梗阻作出定性诊断,并经手术和病理证实为尿路梗阻者。其中尿路结石16例,尿路先天性梗阻4例,输尿管炎性狭窄2例,移植肾输尿管狭窄2例,其他8例。余26例排除上尿路梗阻。结论:MRU是无创伤的检查方法,不接触射线,不需碘对比剂,诊断尿路梗阻性疾病定位、定性准确,尤其适用于因严重梗阻IVP显影不良的病例。     

肾结核磁共振尿路成像特点及与病理变化的关系

目的 探讨磁共振尿路成像(MRU)在肾结核诊断中的价值。方法 18例IVU不显影或IVU显影不良的肾结核患者行MRU，术后结合病理标本分析形成这些影像持点的病理基础。结果 MRU主要影像表现为肾乳头破坏(14例)、肾盏颈部狭窄(14例)、肾盏扩张而肾盂不扩张(10例)、输尿管僵直或狭窄(13例)，可反映出肾结核时尿路不同部位破坏、溃疡、形成空洞与纤维化修复的病理特点。结论 MRU可作为IVU的辅助手段用于肾结核诊断，可提供诊断依据并帮助选择治疗方案。     

Patients at high risk for upper tract urothelial cancer: evaluation of hydronephrosis using high resolution magnetic resonance urography

PURPOSE: We assessed the potential of magnetic resonance urography (MRU) in the evaluation of hydronephrosis not explained by standard investigation in patients at high risk for upper tract urothelial cancer. MATERIALS AND METHODS: A total of 23 consecutive patients in a specialist urological unit with unexplained hydronephrosis prospectively underwent MRU which comprised overview heavily T2-weighted MR urographic images followed by focused high resolution turbo spin echo T2-weighted sequences obtained in an axial and coronal oblique plane through the level of urinary obstruction. All were at high risk for urothelial cancer and had either contraindications to or problems with standard investigations including poor contrast excretion due to obstruction or renal failure, failed ureteral cannulation or contrast allergy. Clinical events and imaging followup, subsequent endoscopic/surgical findings and histopathology validated MR findings. RESULTS: In 23 patients with a high clinical suspicion of upper tract transitional cell tumors (TCC), 8 ureteral and 5 renal pelvic TCCs (2 bilateral) were diagnosed by MR, and confirmed histologically. In a further 5 patients benign causes for the hydronephrosis were found. No intrinsic or extrinsic pathology was demonstrable in 5 patients whose imaging findings were stable during 1 year of followup. CONCLUSIONS: MRU is a valuable noninvasive investigation for evaluating hydronephrosis in this group of patients with suspected urothelial cancer in which routine investigation had failed to provide clinically important information. Focused high resolution T2-weighted images were reliable in the diagnosis of ureteral and renal pelvic TCCs, and were valuable in excluding these and other mass lesions as the cause of hydronephrosis.     

多层螺旋CT对上尿路梗阻性疾病的诊断价值

目的:探讨多层螺旋CT在上尿路梗阻性疾病诊断中的应用价值。方法:对60例上尿路梗阻性疾病的患者行多层螺旋CT平扫加增强检查。结果:60例均获得明确诊断,其中输尿管结石12例,输尿管良性狭窄7例,肾盂输尿管连接部梗阻19例,肾结核9例,巨输尿管2例,输尿管癌5例,输尿管外压迫6例。病因诊断由输尿管镜或开放手术证实。结论:对上尿路梗阻患者,尤其当超声和IVU未能明确诊断梗阻原因时,可以行多层螺旋CT平扫加增强的检查以判断梗阻原因,有助于确诊。     

Simultaneous antegrade urography of the upper urinary tract and retrograde cystography combined with computed tomography imaging in the management of ureteral complications after renal transplantation

BackgroundTo investigate the significance of simultaneous urography of the upper and lower urinary tract of transplanted kidneys combined with computed tomography urography (CTU), computed tomography arteriography (CTA), and computed tomography venography imaging in the planning of open surgery performed to treat any ureteral complications of a transplanted kidney.MethodsIn all, 24 patients with ureteral complications after renal transplantation were admitted, 12 of whom had renal graft ostomy during open surgery. Simultaneous antegrade urography of the upper urinary tract and retrograde cystography of the transplanted kidneys were performed on the patients. With the use of computed tomography imaging results, surgical planning was carried out.ResultsAll surgeries were successfully completed according to preoperative planning. Three patients underwent end-to-end anastomosis of the ureter and bladder muscle flap, 8 patients underwent ureterocystostomy, and 1 patient underwent an end-to-end ureteral anastomosis. After the follow-up up to now, all the patients had stable renal function, and no complications such as ureteral stenosis or urine leakage have thus far reoccurred in the transplanted kidneys.ConclusionsWhen open surgery is required to treat any ureteral complications following renal transplantation, preoperative multiangle imaging can be used to better understand the condition of the transplanted urinary tract and thus aid considerably in surgical planning.     

多层面螺旋CT泌尿系成像的临床应用价值

目的：探讨多层面螺旋CT泌尿系成像(MSCTU)对泌尿系疾病的诊断价值。方法：对以肾绞痛、IVU不显影或血尿为主诉的64例行CT平扫、肾脏增强双期扫描及尿路造影，将资料传至工作站，采用最大强度投影、多平面重建及容积重建等后处理技术，重建泌尿系图像。结果：64例肾盂和膀胱全部显示(100％)，输尿管全程显示者64例(110侧)。其中泌尿系结石16例(25％)；非结石病变48例(75％)，对上尿路梗阻原因诊断正确率100％，并可充分而直观地显示病变立体形态及其与周围组织的关系。结论：MSCTU重建图像清晰，对泌尿系肿瘤、结石或其他上尿路梗阻性疾病有着独特的临床应用价值。     

急性上尿路梗阻性无尿的治疗方法探讨(附58例报告)

目的：探讨急性上尿路梗阻性无尿的应急治疗、病因治疗的方法及效果。方法：对58例确诊为急性上尿路梗阻性无尿患者的应急治疗、病因治疗的方法以及治疗后肾功能恢复情况进行回顾性分析,应急治疗主要为输尿管插管、经皮肾穿刺引流（PCN）、开放性肾造瘘、输尿管腹壁造口和血液透析;病因治疗根据不同病因采取不同方法。结果：应急治疗：39例急诊解除梗阻患者3个月后,24例（61．5％）肾功能恢复正常,12例（30．8％）肾功能明显改善,3例（7．7％）肾功能无改善。病因治疗：27例上尿路结石和4例输尿管狭窄患者成功去除结石和狭窄;14例肿瘤转移侵犯或压迫输尿管和3例腹膜后纤维化患者无法去除病因;3例药物结晶和结核患者均行保守治疗而愈。3例放弃治疗。3个月后,34例（61．8％）肾功能恢复正常,12例（21．8％）肾功能明显改善;9例（16．4％）肾功能无改善。结论：急性上尿路梗阻性无尿的应急治疗顺序依次为输尿管插管、肾造瘘（经皮或开放）及输尿管腹壁造口,尽早解除梗阻可获得较好疗效。上尿路结石、输尿管狭窄、药物结晶、结核等病因可得到解除,腹膜后纤维化、恶性肿瘤等无法去除病因,可行尿流改道。     

计算机断层扫描螺旋尿路成像与仿真内窥镜技术的临床应用

目的 探讨螺旋CT尿路成像（SCTU）与CTVE）的检查方法、成像技术以及在泌尿外科疾病中的应用价值,提高诊断水平。方法 应用螺旋CT对46例泌尿系统疾病患者（包括肾肿瘤2例,肾盂旁囊肿2例,输尿管结石6例,输尿管狭窄4例,输尿管肿瘤2例,重复肾重复输尿管畸形1例,膀胱肿瘤28例,膀胱子宫内膜异位症1例）行容积扫描,所得数据在工作站利用软件进行后处理,获得泌尿系立体图像;并对6例输尿管疾病、29例膀胱疾病患者进行了CT仿真内窥镜（CTVE）成像。所有图像均与B超、静脉尿路造影、逆行肾盂造影、常规CT扫描、膀胱镜检查等比较。并将术中所见或病理结果作为诊断的金标准。结果 所有患者均取得了高质量的泌尿系图像,除1例膀胱肿瘤（肿瘤直径为4mm）漏诊外,其余患者均得到了明确诊断,并与手术或病理结果相符合。结论 SCTU与CTVE是较可靠的非侵入性检查手段,具有一定的优越性,可作为泌尿系常规检查方法的有益补充。