原发性输尿管肿瘤20例的诊断与治疗

目的：提高原发性输尿管恶性肿瘤的诊治水平。方法：对20例原发性输尿管恶生肿瘤做了回顾性分析，比较了各种检查手段。结果：20例均为移行细胞癌，术前确诊15例，占75％，术后随访2月－8年死亡15例。结论：静脉尿路造影、膀胱镜和逆行肾盂输尿管造影是原发性输尿管恶性肿瘤的基本检查手段，肾输尿管全长及膀胱袖套状切除术仍是其主要术式。     

原发性输尿管癌11例

目的提高原发性输尿管癌的诊治水平。方法回顾性分析了11例原发性输尿管癌临床资料,比较各种检查方法,总结诊治经验。结果11例术前经B超、IVU、膀胱镜及逆行肾盂输尿管造影、CT、MRU等检查,术后均行病理检查。结论联合应用B超、IVU、膀胱镜、逆行肾盂输尿管造影和CT、MRU检查方法,可提高原发性输尿管癌的诊断符合率。对本病的诊断治疗进行了讨论,手术以肾、输尿管全长和膀胱袖口状切除术为首选。     

原发性输尿管癌20例诊断和治疗

目的 :为提高原发性输尿管癌的诊治水平。方法 :回顾性分析 2 0例原发性输尿管癌的临床资料 ,总结诊治经验。结果 :2 0例均为移行细胞癌 ,术前确诊 18例 ,占 90 %。 16例获随访 3个月～ 8年 ,死亡 5例 ,2例再发膀胱癌 ,1例再发残端输尿管癌。结论 :膀胱镜检查及逆行输尿管肾盂造影是原发性输尿管癌诊断的重要的检查方法 ,术前联合采用多种检查可提高其诊断率 ;肾输尿管全长切除及膀胱袖口状切除术仍是其主要术式     

B超在原发性输尿管肿瘤诊断中的应用

３２例经病理证实的原发性输尿管肿瘤均行Ｂ超检查。Ｂ超对肿瘤梗阻定位率８４．４％，肿瘤检出率３７．５％，肿瘤检出符合率１００％。与ＩＶＵ、逆行肾盂造影、ＣＴ检查结果对比，Ｂ超对原发性输尿管肿瘤的诊断有较大优越性，因而具有重要价值。对Ｂ超检查的局限性及影响因素也进行了讨论。     

原发性输尿管肿瘤的影像学诊断

目的探讨影像学检查对原发性输尿管肿瘤的检查方法及征像。方法回顾性分析2001年1月-2010年12月经手术病理证实的23例原发输尿管肿瘤影像学表现及征像。结果根据影像学表现,输尿管原发肿瘤多发生于中老年男性输尿管下段,静脉肾盂造影21例检查中,仅3例输尿管腔内充盈缺损。逆行肾输尿管检查18例中,10例插管受阻,显示肿瘤远端呈杯口状改变,5例导管可通过,显示充盈缺损。CT扫描17例中,3例发现输尿管肿块,2例误诊为膀胱肿瘤。B超检查22例中,3例直接探及输尿管肿瘤。结论逆行肾输尿管造影检查对诊断输尿管肿瘤意义重大,诊断符合率为83.3%,CT、B超及静脉肾盂造影远不及逆行肾输尿管造影。膀胱镜检查对某些输尿管下段肿瘤有诊断意义。     

肾盂输尿管连接部梗阻性病变的X线诊断(附14例分析)

目的：探讨静脉肾盂造影和/或逆行造影对肾盂输尿管连接部梗阻性病变诊断的作用。材料与方法：回顾分析了经静脉肾盂造影和/或逆行造影14例肾盂输尿管连接部梗阻性病变的影像学表现。结果：静脉肾盂造影和/或逆行造影能清晰地显示肾盂输尿管连接部梗阻性病变的程度以及肾积水。结论：静脉肾盂造影和/或逆行造影能对梗阻部位和肾功能作出判断，是肾盂输尿管连接部梗阻性病变诊断极为有效的方法。     

原发性输尿管癌的影像诊断（附10例报告）

目的：评价原发性输尿管癌的各种影像学诊断方法的价值。方法：10例原发性输尿管癌均为移行上皮细胞癌。男性6例,女性4例,平均年龄67岁。选择应用了静脉尿路造影、逆行尿路造影、肾穿刺造影、B超和CT扫描。结果：肉眼血尿、腰痛和肾积水是本病三大临床表现。静脉尿路造影（IVU）诊断2例（18．18％）,逆行尿路造影和肾穿刺造影诊断5例（83．33％）,B超对10例均未发现输尿管肿瘤,CT扫描诊断2例。结论：逆行尿路造影为原发性输尿管癌影像学诊断最有价值的方法,CT对肿瘤的分期有一定帮助,B超可做筛选应用。     

输尿管囊肿的影像学诊断

输尿管囊肿是一种少见的先天发育异常。本文搜集 10例 ,均经手术及病理证实 ,现报告于下。1　材料与方法男 6例 ,女 4例。年龄 9～ 40岁 ,病程 10天～ 2年。单侧 8例 ,双侧 2例。单纯型 9例 ,异位型 1例。临床症状 :反复发作尿急、尿频、尿痛 4例 ;血尿 7例 ,排尿困难 2例 ,尿道口有囊性物脱出者 1例 ,无症状者 1例。全部病例均行Ｘ线静脉肾盂造影(ＩＶＰ)、Ｂ超检查 ,1例行ＣＴ扫描 ,4例行膀胱镜检查。2　结果2 .1Ｘ线表现　ＩＶＰ示有肾盂、输尿管积水者 4例 ,伴膀胱憩室者 1例。双侧输尿管囊肿 2例 ,左侧输尿管囊肿 7例 ,右侧输尿管重复…     

逆行球囊导管扩张治疗输尿管狭窄

目的 评价逆行球囊导管扩张输尿管狭窄的治疗效果。方法 对１６例输尿管狭窄的病人（８例吻合口狭窄,５例炎性狭窄,３例先天性狭窄）进行了２２次扩张,其中６例一次扩张无效后作了第二扩张,分别在术后１月、６月进行静脉肾盂造影（ＩＶＰ）和肾功能复查。结果 ＩＶＰ显示病人肾盂积水状况改善表明有效。１６例病人术后１月、６月的有效率均是６２％（１０／１６）。６例有症状的病人中５例半年后恢复正常,５例血清尿素氮（Ｎ     

原发性输尿管肿瘤的诊断体会

原发性输尿管肿瘤临床少见 ,诊断较为复杂 ,主要依靠静脉肾盂造影、逆行造影、膀胱镜、Ｂ超、ＣＴ等。为提高诊断水平 ,作者对 1995年 4月～ 2 0 0 1年 8月收治的原发性输尿管肿瘤 12例的诊断情况进行分析。报告如下 :1　临床资料与方法1 1　资料　本组男 7例 ,女 5例 ;年龄 41～ 72岁 (平均 5 9岁 )。左侧 8例 ,右侧 4例。病程 2个月～ 6ａ。 12例均有程度不等的肉眼血尿 ,6例患侧腰背部及下腹部胀疼 ,5例患侧肾区叩击疼阳性 ,1例伴有尿路刺激症。1 2　方法　本组诊断顺序为 :Ｂ超、尿路造影 (ＩＶＵ )、逆行造影、尿脱落细胞学及ＣＴ。证…     

Primary Renal Candidiasis

Objective. Primary renal candidiasis is rare but increasing in incidence. The purpose of this series is to provide imaging and clinical findings for diagnosing candidiasis and to discuss imaging in the management of this disease. Methods. Ten sonographic, 8 retrograde pyelographic, 2 intravenous pyelographic, 2 antegrade pyelographic, and 2 computed tomographic examinations of 5 patients (4 adult male patients and 1 16‐year‐old female patient) were reviewed. Results. The clinical presentation was variable. Sonography showed renal pelvic wall thickening (n = 5), echogenic debris (n = 4), and fungus balls (n = 2). Papillary necrosis (n = 4), filling defects due to debris (n = 3), and fungus balls (n = 2) were seen on retrograde pyelography. Conclusions. Untreated candidiasis may progress to fungus ball or abscess formation. Sonography is commonly used as the initial imaging procedure. Retrograde and antegrade pyelography are used for biopsy, diagnosis, and treatment. Awareness of this condition and knowledgeable imaging evaluation can help detect and define the site, infection severity, and subsequent therapy.     

原发性输尿管癌的诊断与治疗(附20例报告)

目的:提高原发性输尿管癌的诊断与治疗水平。方法:回顾性分析20例原发性输尿管癌患者的临床表现、诊断与治疗方法。结果:对中老年人不明原因的单侧腰痛、肾积水、间歇性全程肉眼血尿应考虑该病。术前采用B超、IVU、CT、膀胱镜、逆行尿路造影、MRU检查,确诊为原发性输尿管癌14例,术后病理检查20例均为原发性输尿管移行细胞癌。结论:要提高原发性输尿管癌的术前诊断准确率,需要术前采用多种诊断方法。     

Intraductal ultrasonography in the diagnosis of Mirizzi syndrome

BACKGROUND AND STUDY AIMS: Common bile duct (CBD) compression can be caused by stones in the cystic duct (Mirizzi syndrome) which can be difficult to diagnose even with endoscopic retrograde cholangiopancreatography (ERCP). Conventional imaging often gives insufficient information and endoscopic ultrasonography (EUS) and magnetic resonance imaging may improve diagnostic accuracy, but often the final diagnosis is made during exploratory surgery. PATIENTS AND METHODS: All patients undergoing ERCP during a 3-year period were prospectively analyzed if they fulfilled the inclusion criteria: gallbladder in situ; obstructive jaundice with CBD stenosis, demonstrated at endoscopic retrograde cholangiography (ERC), but unexplained at ultrasonography; and inability to demonstrate the cystic duct during ERC. Intraductal ultrasonography (IDUS) was carried out over a guide wire using a 20-MHz probe. Prior to ERCP, patients were evaluated with abdominal ultrasonography and computed tomography (CT), as well as by magnetic resonance cholangiopancreatography (MRCP) or EUS in some. RESULTS: 74 patients out of 2089 undergoing ERCP fulfilled the entry criteria. Final diagnoses, from surgical exploration (n = 41), cytology (n = 21), or endoscopic extraction of stones from the cystic duct (n = 12), were Mirizzi syndrome (type I) in 30 patients and other causes in 44 patients (gallbladder carcinoma [n = 16], pancreatic carcinoma [n = 9], metastatic compression [n = 9], other [n = 10]). CT had shown suspected Mirizzi syndrome in 1/30 cases (3 %) and MRCP in 12/19 evaluated cases (63 %). EUS allowed a correct diagnosis in 11 of 15 evaluated cases (73 %). IDUS required an additional 8 +/- 3 min and showed a sensitivity of 97 % and specificity of 100 %. CONCLUSION: IDUS is a sensitive and specific method for the diagnosis of Mirizzi syndrome.     

原发性输尿管肿瘤的诊断与治疗（附16例报道）

目的探讨原发性输尿管肿瘤的早期诊断方法与治疗。方法回顾分析我院2003年8月至2009年3月收治的16例输尿管肿瘤患者的诊断方法及治疗。结果通过超声检查、排泄性静脉尿路造影、逆行肾盂造影、CT、输尿管镜及脱落细胞学检查等,术前诊断符合率为93.8%（15/16）。除1例行快速病理检查证实为息肉外,其余均为输尿管肿瘤。全部肿瘤患者除1例外,均行患侧肾、输尿管全切和膀胱袖状切除。结论多种检查方法相结合是原发性输尿管肿瘤早期诊断与治疗的关键。     

Sonographic diagnosis of ureteral tumors.

We present our experience with transabdominal ultrasonographic diagnosis of ureteral tumors. During the years 1989 to 1998, 16 patients were diagnosed as having ureteral tumors. These patients were referred for sonographic examination for evaluation of hematuria (seven patients) or flank pain (four patients) or for follow-up screening in patients who were asymptomatic but at high risk for transitional cell carcinoma because of known past bladder tumor (five patients). Ten of these patients underwent intravenous urography examination, three patients had retrograde pyelography, and 11 patients underwent CT scanning. Ultrasonography revealed the ureteral tumors in all 16 patients, which appeared as hypoechoic intraluminal soft tissue. Three tumors were localized in the upper ureter, four in the middle ureter, and nine in the distal ureter. The degree of ureterohydronephrosis was minimal (two cases), mild (five cases), moderate (eight cases), or severe (one case). Eleven tumors caused local widening of the ureteral diameter. On intravenous urography, four patients had a nonfunctioning kidney, three patients had unexplained ureterohydronephrosis, and three patients showed ureteral filling defects, of which only two had irregular contours. On retrograde pyelography, two patients had filling defects (one of which with smooth margins), and one had a truncated ureter. On CT the tumor was clearly demonstrated in only seven patients. We found that ultrasonography can be a useful diagnostic tool in the workup of ureteral tumors.     

可变形图像配准的CT与MRI对肝癌体积测定的前瞻性比较

目的 通过比较MRI与CT对肝癌肿瘤的诊断情况,进而进行高精度放疗计划。方法 选择2020年7月～2022年7月收治的26例不可切除的肝转移(n=8)、肝细胞癌(n=10)和胆管癌(n=8)患者作为研究对象,患者在放疗计划时进行了具有诊断质量的MRI扫描和三期CT扫描,并确定了肝内解剖参考点。在最能显示肿瘤的CT和MRI系列中,勾画了肝脏和肿瘤体积,确定了肝内解剖参考点。采用形变配准对CT和MRI的肝脏进行配准。结果 5例肝癌CT病灶数量与MRI有差异,MRI病灶多3例,CT病灶多2例。肝脏变形配准后,CT肿瘤表面与MRI肿瘤表面平均距离的人群中位数为3.7(2.2～21.3)mm。肿瘤表面积相差5mm的中位百分比为26%(38%～86%)。转移瘤的中位符合率为81%(77%～86%),肝细胞癌的一致性为78%(44%～86%),胆管癌的一致性为69%(25%～85%)。结论 MRI诊断的肝癌肿瘤体积与CT诊断的肝癌肿瘤体积存在显著差异,且在原发性肝癌中更为常见。     

数字化成像在泌尿系检查中的临床应用

目的 评价数字化成像在泌尿系统检查的临床应用价值。方法 采用数字化成像对112例患者进行尿路造影检查，包括38例静脉尿路造影（IVP），74例逆行尿路造影。结果 运用数字化成像能较好地显示尿路全程，对输尿管结石有较高的诊断价值，对尿路梗阻能作出准确的定位及定性诊断。IVP检查38例中，5例显影正常，肾结石12例，输尿管结石13例，输尿管狭窄6例，肾母细胞瘤2例。逆行尿路造影74例中，输尿管良性狭窄31例，输尿管结石27例，输尿管息肉2例，尿道结石8例，尿道良性狭窄6例。结论 数字化成像技术在泌尿系统疾病诊断中有较大的应用价值。