IVP、CTU及MRU在儿童重复肾畸形中的诊断价值

发布时间：2018-04-10 03:18

本文选题：儿童　切入点：重复肾　出处：《中国医学计算机成像杂志》2015年06期

【摘要】：目的:探讨静脉肾盂造影(IVP)、CT尿路造影(CTU)、磁共振尿路造影(MRU)在儿童重复肾畸形中的诊断价值。方法:回顾性分析经临床证实的43例儿童重复肾的影像资料,比较IVP、CTU及MRU在显示儿童重复肾方面各自优势与不足。结果:左侧病变25例,右侧病变13例,双侧病变5例。其中有8例合并重复输尿管异位开口,18例伴有输尿管囊肿。IVP可见重复肾多位于上肾段,大多能显影,对于发育型或轻度积水型重复肾功能显示良好。同时可见完全型或不完全型输尿管重复畸形,并伴有输尿管囊肿。CTU可见重复肾的肾盂肾盏明显扩张,重复肾的动脉供血和静脉回流情况,输尿管的迂曲扩张和梗阻部位。MRU对功能不佳或积水严重重复肾可显示其肾脏内部结构,输尿管的形态和走行。结论:IVP可显示功能正常的重复肾,但其对积水型严重的重复肾畸形则无法显示。CTU虽然能很好显示各类畸形,也能反映重复肾功能状态,但是X线辐射相对较大、且对比剂可能造成不良反应。MRU虽然无法了解重复肾功能,但它无需对比剂、能很好显示积水型重复肾畸形,同时避免了X线照射。因此,MRU和IVP联合应用可以优势互补、提高重复肾畸形的诊断率。
[Abstract]:Objective: to evaluate the diagnostic value of intravenous pyelography (IVP) CT urography (CTU) and magnetic resonance urography (MRU) in children with duplicate renal malformation.Methods: the imaging data of 43 children with repeated kidney were analyzed retrospectively, and the advantages and disadvantages of IVP CTU and MRU in displaying repeated kidney in children were compared.Results: there were 25 cases of left side lesions, 13 cases of right side lesions and 5 cases of bilateral lesions.In 8 cases with ureteral ectopic orifice, 18 cases were accompanied with ureteral cyst. IVP showed that most of them were located in the upper renal segment, and most of them were able to develop, and showed good duplicate renal function for developmental type or mild hydronephrosis type.At the same time, complete or incomplete ureteral duplication was seen, accompanied by ureteral cyst. CTU showed obvious dilatation of renal pelvis and calyceal, arterial blood supply and venous reflux of duplicate kidney.Ureteral dilatation and obstruction. MRU can show the internal structure of the kidney, the shape and movement of the ureter in patients with poor function or severe hydronephrosis.ConclusionVIVP can display normal duplicate kidney, but it can not show all kinds of deformities in hydronephrosis, CTU can show all kinds of deformities, but X-ray radiation is relatively high.The contrast agent may cause adverse reactions. MRU can not understand the function of repeated kidney, but it does not need contrast agent, it can well display hydronephrosis and avoid X-ray irradiation.Therefore, the combination of MRU and IVP can complement each other and improve the diagnosis rate of duplicated renal malformation.
【作者单位】：南京医科大学附属南京儿童医院放射科;
【分类号】：R726.9;R816.92

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