肾盂输尿管重复畸形的影像学评价

目的:分析肾盂输尿管重复畸形的影像学表现,评价各种影像学检查方法的诊断价值。方法:回顾分析13例经手术病理证实肾盂输尿管重复畸形的影像学资料(其中1例为双侧),13例均行静脉肾盂造影(IVU)和MRI平扫及磁共振水成像(MRU),其中4例行逆行造影,5例行CT扫描。结果:13例共14只肾盂输尿管重复MRI均能诊断,仅其中2例输尿管无积水扩张者未显示重复输尿管之汇合处,诊断准确率84.6%(11/13);13例IVU明确显示4例重复畸形,2例延迟显影才能诊断,6例肾盂输尿管重复未显影未能明确诊断,1例双侧重复畸形仅显示其中1侧,诊断符合率46.2%(6/13);4例逆行造影显示2例,1例输尿管下端肿瘤梗阻,另1例完全重复输尿管异位开口均插管失败,成功率50%(2/4);5例CT明确诊断4例,1例上段肾盂囊状扩张无肾盏误诊为囊肿,诊断符合率80%(4/5)。结论:肾盂输尿管重复畸形类型多样,依有无并发症而病理和影像不一,各种影像学检查方法各有其利弊,肾功能不良或伴输尿管异位开口者以CT和MRI结合MRU较适合。

Imaging Diagnosis of Duplication of Renal Pelvis and Ureter

Objective:To study the manifestations of renal pelvis and ureter duplication abnormality on MRI,MRU,CT and IVU imaging,and to investigate the value of different imaging examinations.Methods:In 13 cases of renal pelvis and ureter duplication abnormality proved by operation and pathology,the images of MRI,MRU,CT and IVU were analyzed retrospectively.13 cases all underwent MRI,MRU and IVU examinations,in addition,4 cases with retrograde urography,and 5 cases with CT scan.Results:13 cases by MRI and MRU could all be diagnosed.Diagnosis accuracy rate was 84.6%;4 cases were clearly displayed with duplication abnormality by IVU;2 cases could also be diagnosed with delayed urography imaging;6 cases couldn't be diagnosed without urography imaging.Diagnosis accuracy rate was 46.2%;in the 4 cases of retrograde urography,2 case showed the images and 2 cases didn't due to failure of intubation.Diagnosis accuracy rate was 50%; 4 cases were definitely diagnosed with CT scan,1 case of upper renal pelvis dilation was misdiagnosed as cystis diagnosis accuracy rate was 80%.Conclusion:Renal pelvis and ureter duplication abnormality are diverse in type.The pathology and images vary with whether there are complications.There exist advantages and disadvantages in each imaging inspection,IVU and CT are suitable for cases without complications and with normal function of the kidney.MRI is preferable to unhealthy kidneys.Retrograde urography is considered only when other image inspections are unavailable for diagnosis.