重复肾和重复输尿管畸形的影像诊断

目的:探讨重复肾和重复输尿管静脉尿路造影术(IVU)、CT尿路造影(CTU)及MR尿路造影(MRU)影像形态学特点、病理基础及其诊断价值。方法:40例重复肾和重复输尿管中,无积水型25例、积水型15例均进行IVU;15例积水型进行CTU及MRU。结果:25例无积水型,临床多无症状,体检时偶尔发现,无并发症者IVU显影满意,临床无需特殊处理。15例积水型,临床表现腹部胀痛,腰酸,腹部触及包块,IVU不显影或显影不满意,CTU及MRU表现重复肾萎缩及重复输尿管扩张,重复肾囊状扩张及重复输尿管异位开口。重复输尿管异位开口表现正常排尿间的滴沥性尿失禁及尿路反复感染。结论:CTU及MRU检查可明确积水型重复肾和重复输尿管性质,影像形态学不但能明确诊断而且为临床选择手术方式起着重要作用。

Diagnostic Imaging of Renal Duplication and Duplication of Ureter

Objective：To investigate the feature of image morphology, the groundwork of pathology and the diagnostic value of the renal duplication and deformity of ureter in intravenous urography（IVU）,computed tomography ureter（CTU）, magnetic resonance tlreter （MRU）. Methods：All of 40 cases with the renal duplication and deformity of ureter were given intraven.ous urography in which there were 25 cases with no hydrops and 15 cases with hydrops.Then the 15 cases with hydrops given CTU and MRU.Results：the 25 cases with no hydrops had such features as symptomless in clinical,no complications, satisfactory visualization in IVU and without special handling.But thel5 cases with hydrops had such features as abdomen gas pains in abdomen, waist soreness, palpable, lump in abdomen, nonvisulization or diasatisfactory visualization in IVU,In CTU and MRU had following features： the renal duplication ~trophy or duplication distention of ureter,the scrotiform distention in renal duplication,duplication ectopic ureterostoma which had uroclepsia and repeated infection. Conclusion：CTU and MRU could identify the character and image morphology of the category of hydrops in the renal duplication and duplication of ureter .They not only can diagnosis it ,but also can provide the operating way for clinical.