下腔静脉后输尿管的影像诊断价值

目的评价影像学检查在下腔静脉后输尿管的诊断价值。方法对7例下腔静脉后输尿管的B超、静脉尿路造影(IVU)、逆行尿路造影(RGU)及CT、MR成像的影像资料进行回顾性分析和比较。结果 B超检查7例显示右侧输尿管上段并右肾积水;IVU检查7例可见输尿管上段呈反"J"征,移行段以上输尿管及肾盂、肾盏不同程度扩张积水;RGU检查7例所见移行段以上之输尿管及肾盂、肾盏表现与IVU检查所见相似,患侧输尿管全程显影;CT扫描2例显示右侧输尿管在腰3~4平面水平于腔静脉的后侧及内外侧显影;MR检查1例显示输尿管于下腔静脉外后绕至下腔静脉内前侧。7例均于术前获得明确诊断并进行了手术,证实为右侧下腔静脉后输尿管。结论多种影像学的协同检查为下腔静脉后输尿管的诊断提供了主要依据,是诊断下腔静脉后输尿管的可靠方法。

Imaging Diagnosis of Retrocaval Ureter

Objective To evaluate the diagnosis value of imaging examination in retrocaval ureter.Methods Retrospective analyses and comparisons were carried out for imaging data of B ultrasound,intravenous urography（IVU）,retrograde urography（RGU） and CT and MR imaging of 7 cases.Results B ultrasound examination showed that there was hydronephrosis on right upper ureter and right kidney for 7 cases;IVU examination showed that upper ureter presenting reverse ＂J＂ sign.Also,above the ureter in this transitional segment and renal pelvis and calyces had different extends of dilatation hydrocephalus for 7 cases;RGU examination showed that for 7 cases,manifestations of ureter over migration segment and renal pelvis and calyces were similar to those of IVU examination,and sick-side ureter developed fully.CT scanning examination of 2 cases showed that right ureter at waist 3-4 level developed in the posterior lateral and interior-outside lateral of vena cava.MR examination of 1 case showed that ureter wound from outer-rear side of inferior vena cava.Seven cases were definitely diagnosed preoperatively and received operation,and the retrocaval ureter was confirmed.Conclusion Multiple-imaging cooperative examination provided an important basis for diagnosis of retrocaval ureter,and it was a reliable method for diagnosis of retrocaval ureter.