先天性巨输尿管症的X线尿路造影检查（附15例报告）

目的分析、评价先天性巨输尿管症X线尿路造影检查的影像特征、检查技巧及临床价值。方法分析15例经手术、病理证实的先天性巨输尿管症的X线尿路造影片及造影时的动态观察记录。结果（1）单或双侧输尿管扩张始于盆段，且呈上行渐进性发展，造成肾盂肾盏扩张，扩张的输尿管可发生迂曲改变。而扩张输尿管末端临近膀胱入口处管径正常，为功能性梗阻段，长度为1～2cm；（2）除功能性梗阻段以外，其余段输尿管的蠕动一般正常，早期有时可见高蠕动；（3）扩张输尿管排空延迟；（4）无膀胱输尿管返流；（5）本病的X线造影检查应选用大剂量静脉尿路造影，造影时早期解除腹压带，增加延迟摄片，并加照膀胱斜位点片，加强动态观察。结论X线尿路造影是对先天性巨输尿管症进行诊断、随访及术后疗效观察的一种最适宜的检查方法。

Diagnosis of Congenital Megaureter by Urography(A Report of 15 Cases)

Objective:To evaluate the imaging features,examination techniqueand clinical value of X-ray urography of congenital megaureter.Methods:15 cases with congenital megaureter confirmed by operation and pathology were reviewed.Results:One or two ureters were involved.The dilation of the involved ureter arose from the pelvic segment of ureter except the last terminal segment of involved ureter which was normal in calibre and was 1～2 cm long.The peristalses of the dilated ureter could be seen but it disappeared in the end of the ionvolved ureter,which was of normal calibrc.Delay in the empty of ureter was seen.The ureter counter current from the bladder could not be found.Conclusion:The X-ray urography is the optimal way for the congenital megaureter in its diagnosis,followed up and the evaluation of treatment effect.