机构地区:[1]广东省深圳市宝安区人民医院泌尿外科,518101 [2]广东省深圳市宝安区人民医院超声科,518101 [3]广东省深圳市松岗人民医院放射科
出 处:《实用医学影像杂志》2023年第1期35-37,共3页Journal of Practical Medical Imaging
基 金:广东省深圳市宝安区科技计划项目(2013012)。
摘 要:目的评价磁共振成像(MRI)在妊娠期泌尿系急腹症病因查找及病情评估中临床价值。方法收集2015年1月至2020年12月住院治疗且均行泌尿系MRI检查的妊娠期泌尿系急腹症患者20例的临床及影像学资料,将MRI所见与超声表现、临床治疗随访情况比较,评价MRI在妊娠期泌尿系急腹症病因查找及病情评估的临床意义。结果①MRI表现:9例表现为双侧输尿管跨越髂动脉处明显受压变窄伴双肾及输尿管轻度扩张积液;8例表现为单侧输尿管跨越髂动脉处明显受压变窄(1例输尿管受压狭窄处管壁明显增厚改变)伴同侧肾盂及输尿管轻度扩张积液;12例可见肾周筋膜稍增厚、脂肪间隙内渗出改变,其中1例双侧肾脏及7例单侧肾脏体积明显增大伴肾实质多发片状扩散加权成像(DWI)高信号及T2加权成像(T2WI)稍高信号;肾结石3例,输尿管结石2例。②14例患者经临床采用单纯抗感染、解痉止痛治疗后临床症状明显改善后出院;5例患者经临床抗感染、解痉止痛并D-J管植入(2例激光碎石)后临床症状明显改善后出院;1例抗感染、解痉止痛并激光碎石后临床症状明显改善后出院。结论MRI在妊娠期泌尿系感染及病情评估具有重要的临床价值,DWI对肾实质早期损害具有较高的敏感性,但对肾盂肾盏及输尿管小结石观察价值有限。Objective To evaluate the clinical application value of magnetic resonance imaging(MRI)in finding the cause of urinary emergency during pregnancy and evaluating the condition.Methods The clinical and imaging data of 20 patients with urinary emergency during pregnancy who were hospitalized from January 2015 to October 2020 and all underwent urinary MRI examination were collected,and MRI and ultrasound findings and clinical follow-up were compared.Evaluate the clinical significance of MRI in the etiology and disease assessment of acute abdomen of urinary system during pregnancy.Results①MRI findings:9 cases showed obvious compression and narrowing of bilateral ureter crossing iliac artery with mild dilation and effusion of both kidneys and ureter,8 cases showed obvious compression and narrowing of unilateral ureter crossing iliac artery(1 case with ureteral compression and stenosis markedly thickened the wall of the tube)with mild dilated effusion of the ipsilateral renal pelvis and ureter,12 cases showed slight thickening of the perirenal fascia and changes in the leakage of the fat space,including 1 case with bilateral kidney and 7 cases with unilateral kidney volume increased obviously with renal parenchyma multiple high signal on DWI and slightly high signal on T2WI.There were 3 cases with kidney stones and 2 cases with ureteral stones.②Forteen patients were discharged after clinically treated with simple anti-infection,antispasmodic and analgesic treatments,and their clinical symptoms were significantly improved,5 patients received clinical anti-infection,antispasmodic and analgesic treatment and D-J tube implantation(2 of which were treated with laser lithotripsy),the clinical symptoms improved significantly and he was discharged,one case was discharged after anti-infection,antispasmodic and pain relief combined with laser lithotripsy,and the clinical symptoms improved significantly.Conclusion MRI has important clinical value in the evaluation of urinary infections during pregnancy.DWI is highly sensitive
分 类 号:R445.1[医药卫生—影像医学与核医学] R714.258[医药卫生—诊断学]
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