先天性肾盂输尿管连接部梗阻的X线表现和病因诊断

目的 :探讨先天性肾盂输尿管连接部 (PUJ)梗阻的X线表现 ,提高X线检查对先天性PUJ梗阻的病因诊断的准确性。方法 :对 2 1例经手术证实的先天性PUJ梗阻的临床资料进行回顾性分析。本组 2 1例均在透视下行静脉尿路造影 (IVU) ,9例行逆行性造影 (RGU)。结果 :PUJ狭窄 10例 ,输尿管高位附着 2例 ,肾脏旋转不良 3例 ,迷走血管 5例 ,纤维束带 1例。讨论 :综合分析PUJ狭窄段的X线形态表现 ,对大多数先天性PUJ梗阻病因可作出诊断 ,延迟IVU、RGU和电透下观察PUJ狭窄段的形态学表现是最常用和最有效的检查手段。

X-ray manifestations and the causes of congenital pyeioureteric junction obstruction

Objective:To improve the diagnostic accuracy of the cause of congenital pyeloureteric junction (CPJ) obstruction by investigating its X-ray manifestations.Methods:Clinical materials in 21 patients with CPJ proved by surgical findings were retrospectively analyzed. All of 21 cases carried out excretory urography (IVU) aided by fluoroscopy,and 9 of them were performed additional retrograde urography(RGU).Results:In 21 cases of CPJ, there was stenosis of CPJ in 10, high positioned ureter in 2, malrotation of kidney in 3,abarrent vessel in 5 and fibrous bundle in 1. Conclusion:Comprehensive analysis of X-ray manifestations of stenostic segment of CPJ could determine the causes of CPJ obstruction in most cases.Delayed IVU and RGU under fluoroscopy are the most common and effective methods in the demonstration of stenostic segment of pyeloureteric junction.