经皮穿刺上尿路顺行造影超声检查及其临床意义  

Antegrade Contrast-enhanced Ultrasound Examination of Upper Urinary Tracts Through Percutaneous Renal Pelvis Puncture and Its Clinical Significance

作　　者：章建全[1] 孟进[1] 季秀凤[1] 陈佳彬[1] 肖燕[1] 

机构地区：[1]解放军第二军医大学附属长征医院超声诊疗科,上海市200003

出　　处：《中国超声医学杂志》2007年第6期469-472,共4页Chinese Journal of Ultrasound in Medicine

基　　金：长征医学"三重三优"学科和人才建设专项基金(No.2005-03-16)

摘　　要：目的探讨上尿路系统内直接使用超声造影剂SonoVue进行造影超声检查的方法和临床意义。方法以6例上尿路梗阻患者为研究对象,在进行经皮肾盂穿刺引流手术过程中从引流管直接向肾盂内注射SonoVue2ml（4.8mg/5ml）＋20~40ml灭菌生理盐水。在对比脉冲序列（contrast pulsed sequence,CPS）造影模式下连续观察造影剂强回声从肾盂向输尿管、膀胱运动的过程。造影结束后将尿路内的液体全部吸出,并反复多次冲洗至造影剂强回声明显减弱。结果发现输尿管破裂1例,输尿管肿瘤2例,输尿管开口异位2例。结论经皮肾盂穿刺顺行上尿路造影超声检查是SonoVue非血管途径应用的新尝试,能够诊断常规超声、彩色多普勒超声不能或不明确诊断的梗阻性尿路疾病。临床观察未发现造影剂导致尿路并发症。Objective To assess the technical feasibility and clinical significance of contrast-enhanced ultrasound examination of upper urinary tract by a non-vascular approach of injecting SonoVue agents through percutaneous puncture of renal pelvis. Methods Between May and September 2006, 6 patients with unilateral hydroureteronephrosis were selected. After an inform-consent, they all received a percutaneous puncture nephrostomy under ultrasound control. During the procedure a dose of 2 ml SonoVue agents （4. 8 mg per 5 ml） dissolved in 20 to 40 ml sterilized saline was administered through injection into the renal pelvis via the puncture tube. Antegrade contrast agent movement within upper urinary tract was continuously monitored under CPS mode. On the end of contrasting procedure, liquid with agents within the urinary tract was extracted thoroughly. Results Antegrade ureteral CEUS revealed 1 case with upper ureteral rupture, 2 with ureteral tumor, and 2 with ureteral osteum ectopia as well. Conclusions Antegrade urography by way of percutaneous puncture of renal pelvis is a method important to estimate the causes, sites, and extents of ureteral obstruction. By this means, we succeeded in detecting those entities failed to be demonstrated on conventional ultrasound or even color Doppler ultrasound examinations. In addition, local administration of SonoVue contrast agents in upper urinary tract has resulted in no complications according to clinical observations.

关 键 词：输尿管破裂 输尿管肿瘤 输尿管开口异位 顺行尿路超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学]