彩色多普勒超声及计算机断层扫描血管造影术对腹膜后纤维化的诊断价值及随访分析  

Value of color doppler ultrasonography and computerized tomography angiography in the diagnosis and follow-up of retroperitoneal fibrosis

作　　者：王慧[1] 李梓伦[1] 姚陈[1] 黄雪玲[1] 王深明[1] 常光其[1] Wang Hui;Li Zilun;Yao Chen;Huang Xueling;Wang Shenming;Chang Guangqi(Department of Vascular Surgery,the First Affiliated Hospital of Sun Yat-sen University,National-Local Joint Engineering Laboratory of Vascular Disease Treatment,Guangdong Engineering and Technology Center for Diagnosis and Treatment of Vascular Diseases,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院血管外科血管疾病诊治技术国家地方联合工程实验室广东省血管疾病诊治工程技术研究中心,广州510080

出　　处：《中华普通外科学文献（电子版）》2022年第2期127-130,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨彩色多普勒超声(CDU)及计算机断层扫描血管造影术(CTA)对腹膜后纤维化(RPF)诊断及随访价值。方法回顾性分析2016年1月至2021年12月中山大学附属第一医院收治并诊断为RPF患者18例。对RPF组织回声特点、累及范围、组织厚度进行比较;评估腹主动脉、下腔静脉、髂动脉血流情况以及输尿管是否扩张、有无肾积水等。随访分析患者的治疗效果。结果18例患者中,单侧肾积水8例,双侧6例;单侧输尿管扩张5例,双侧8例。17例进行CTA检查,1例仅累及内脏动脉,1例仅累及髂内动脉,15例不同程度累及腹主动脉及髂动脉,下腔静脉被包绕者7例。8例进行CDU检查,1例累及髂内动脉者漏诊,其余患者CDU检查与CTA检查结果一致。两者测量RPF厚度差异无统计学意义。平均随访时间36.2(5~66)个月,其中12例患者随访症状均有明显改善。3例CDU及CTA随访纤维化组织厚度较治疗前明显缩小。结论利用CDU及CTA对RPF影像学特点、病变范围、肾脏、输尿管及受累大血管与纤维组织之间的关系病变等进行多角度分析,可以提高对RPF诊断的准确性,避免漏诊及误诊,对RPF的早期诊断、治疗及随访具有重要的意义。Objective To study the value of color doppler ultrasonography(CDU)and computerized tomography angiography(CTA)in the diagnosis and follow-up of retroperitoneal fibrosis(RPF).Methods A total of 18 cases with RPF who were identified in the First Affiliated Hospital of Sun Yat?sen University from January 2016 to December 2021 were retrospectively analyzed.The echo characteristics of tissue,range,and the thickness of tissue was compared.The patency of abdominal aorta,inferior vena cava,iliac artery and the dilated ureter,hydronephrosis were analyzed.All the patients were followed up and evaluated.Results 8 cases were with unilateral hydronephrosis,6 cases with bilateral hydronephrosis.Unilateral ureteral dilation in 5 cases,bilateral ureteral dilation in 8 cases,and 17 cases were detected by CTA.Visceral artery was involved in 1 case.The internal iliac artery was only involved in 1 case.Abdominal aorta and iliac artery were involved in 15 cases.The inferior vena cava was surrounded and compressed by fibrous tissue in 7 cases.8 cases were detected by CDU.1 case of internal iliac artery involvement was missed.The results of CDU and CTA were consistent in other patients.There was no significant difference between the comparison for the thickness of tissue which was detected by CTA and CDU.The mean follow-up time was 36.2(5-66)months.The symptoms of all 12 patients were significantly improved.The scope and thickness of fibrosis involvement in 3 cases were significantly reduced compared with before treatment.Conclusions CDU combined with CTA can be used to analyze the imaging characteristics of RPF,the scope of involvement and the relationship between kidney,ureter,blood vessels and fibrous tissue from multiple perspectives,to improve diagnostic accuracy of RPF,and avoid missed diagnosis and misdiagnosis,which is of great significance for the early diagnosis,treatment and follow-up of RPF.

关 键 词：超声检查 多普勒 彩色 腹膜后纤维化 诊断 随访 计算机断层扫描血管造影术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R572.2[医药卫生—诊断学]