MRI在下腔静脉后输尿管中的诊断价值  

Diagnostic value of MRI in the diagnosis of retrocaval ureter

作　　者：冯仕庭[1] 郭欢仪[2] 孙灿辉[1] 范淼[1] 蔡华崧[1] 郭燕[1] 李子平[1] 李向民[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080 [2]中山大学附属第三医院超声科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2010年第5期52-55,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的总结下腔静脉后输尿管的影像表现,探讨磁共振尿路成像在该病诊断中的价值。方法回顾性分析9例经手术证实的下腔静脉后输尿管的影像表现,所有病例均行常规磁共振尿路成像MRI及MRU检查;9例行腹部超声检查;8例行腹平片(KUB)及静脉肾盂造影(IVP),其中3例加做逆行肾盂输尿管造影(RUP);3例行中下腹部、盆腔CT检查。结果本组9例下腔静脉后输尿管均发生于右侧,其中8例为Ⅰ型(低袢型),右输尿管呈鱼钩形或"S"形改变;1例为Ⅱ型(高袢型),右输尿管呈"倒置J"形。超声准确诊断1例、静脉肾盂造影(IVP)结合逆行肾盂造影(RUP)检查,准确诊断6例。3例CT检查均能准确诊断。常规MR横断T2加权(MRT2WI)结合MRU检查,8例能准确诊断,诊断准确率为89%。结论 MRI对该病的诊断准确率非常高,而且对人体无生物学损害,具有很高的临床实用价值。Objective To summarize the imaging charactars of retrocaval ureter and investigate the clinical application value of magnetic resonance imaging （MRI） in diagnosis of retrocaval ureter. Methods Nine cases of retrocaval ureter confirmed by surgery were enrolled in the study. MR examination including conventional abdominal scanning sequence and magnetic resonance urography （MRU） and ultrasound examination were performed in all the patients. Eight of nine patients were undergone intravenous pyelography （IVP）, and three of them received retrograde pyelography （RUP） at the same time. Three of nine patients undergone abdominal and pelvic CT examination. Results All the nine cases of retrocaval ureter were occurred in the right side. According to Bateson typing, there were eight cases and one case with type I and type Ⅱ, respectively. ‘S＇ -like ureter was found in the cases with type I , while inverted ‘J＇ -like ureter was found in the cases with type Ⅱ. Only one case could be diagnosed correctly by uhrasonography and the diangostic accurate rate was 11%（1/9）. Six of eight cases were diagnosed correctly by IVP combined with RUP and the the diagnostic accurate rate was 75%（6/8）, while all the three cases was diangosed correctly by CT examination. Eight of night cases were diagnosed correcdy by MRI T2 weighted imaging （T2WI） combined with MRU and the diagnostic accurate rate was 89%. Conclusions MR examination plays an important role in the diagnosis of retrocaval ureter due to its high diagnstic accurate rate and no biological damage.

关 键 词：磁共振 下腔静脉后输尿管 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]