摘要
目的:探讨标准化泌尿系超声检查流程在儿童输尿管纤维上皮性息肉(UFP)致肾积水术前诊断及预后评估中的价值。方法:回顾性分析2017年1月~2022年1月行UFP切除术的43例患者的临床资料,术前患者行超声检查前30 min内大量饮水(500~1000 mL),超声仔细检查肾盂、肾盂输尿管连接部和近端输尿管是否有肿块导致肾积水,手术后3及6个月复查泌尿系超声。结果:43例患者中男42例(97.7%),女1例(2.3%),年龄3~15岁,平均(9±3)岁。单发40例,多发3例;左侧输尿管息肉37例(44枚),右侧输尿管息肉4例(4枚),双侧输尿管息肉2例(4枚)。超声于术前准确定位并正确诊断31例(35枚),诊断符合率为72.1%(31/43),其中左侧输尿管息肉30枚,右侧输尿管息肉1枚,2例患者双侧输尿管息肉共4枚。息肉呈条索状、乳头状或柱状,低回声,边界清晰,彩色多普勒示息肉内可见血流信号,频谱呈低速高阻型,息肉中位长度为15 mm(5~50 mm)。所有病例的息肉经手术完整切除并取得病理结果,术后均进行随访,无1例息肉复发,积水程度均较术前减小,差异具有统计学意义(P<0.05)。结论:超声对UFP引起的肾盂输尿管连接部梗阻有较高的诊断价值,并可有效评估患儿预后。
Objective:To explore the value of standardized urological ultrasonography in preoperative diagnosis and prognosis evaluation of hydronephrosis caused by ureteral fibroepithelial polyps(UFP)in children.Methods:The clinical data of 43 patients who underwent UFP resection from January 2017 to January 2022 were retrospectively analyzed.The patients drank a large amount of water(500~1000mL)within 30 minutes before the ultrasound examination before surgery.The renal pelvis,ureteropelvic junction,and proximal ureter were carefully examined for mass resulting in hydronephrosis.Urinary ultrasonography was repeated 3 and 6 months after surgery.Results:Among the 43 patients,there were 42 males(97.7%)and one female(2.3%),aged from 3 to 15 years,with an average age of(9±3)years.Forty cases were single,and 3 cases were multiple.There were 37 cases(44)of left ureteral polyps,4 cases(4)of right ureteral polyps,and 2 cases(4 cases)of bilateral ureteral polyps.Thirty-one cases(35)were correctly diagnosed preoperatively by using ultrasonography,with a diagnostic accuracy rate of 72.1%(23/37),including 30 left ureteral polyps,one right ureteral polyps,2 cases had four bilateral ureteral polyps.The polyps were cord-shaped,papillary,or columnar,with low echo and clear boundaries.Color Doppler imaging showed blood flow signals were visible within the polyps,with a low velocity and high impedance spectrum.The median length of polyps was 15mm(5~50mm).All cases of polyps were completely removed by surgery,and pathological results were obtained.All patients were followed up after surgery.No polyp recurred,and the degree of hydrops decreased compared to before surgery,with statistical significance(P<0.05).Conclusions:Ultrasonography is valuable in diagnosing ureteropelvic junction obstruction caused by UFP and can effectively evaluate the prognosis of patients.
作者
张倩
刘浩
周昕
陈俊
朱善良
ZHANG Qian;LIU Hao;ZHOU Xin(Department of Ultrasonography,Children's Hospital of Nanjing Medical University,Nanjing 210017,China)
出处
《放射学实践》
CSCD
北大核心
2023年第9期1195-1199,共5页
Radiologic Practice
