【摘要】 目的 观察利尿肾动态显像(DR)在婴幼儿后尿道瓣膜中的影像表现,探讨用DR进行术后随访的评价方法。方法 患先天性后尿道瓣膜的男性患儿22例,年龄2月-10岁。术前1周内行DR检查,根据DR结果对肾积水进行分度,并对术后随访结果进行评分,负值=恶化;0=无改变;1％-32％=满意;33％-65％=良好;>66％=优。结果 所有病例肾盂均有放射性滞留,40只肾累及肾盏(90.9％);输尿管全段扩张显影34根(77.3％);膀胱无充盈8例,扩大1例,缩小9例。随访结果,“恶化”2肾,“无改变”6肾,“满意”3肾,“良好”3肾,“优”1肾。结论 DR可观察到先天性后尿道瓣膜中上尿路各个部位较具特征性的改变,可帮助诊治;用于术后结果的评价,较为全面、准确及实用。更多还原

【Abstract】 Objective To study the imaging and evaluate follow-up furosemide plus 15-minute diuretic renography (F + 15 DR) in neonates and infants with posterior urethral valve. Methods Twenty-two patients with posterior urethral valve were examined with DR before surgery. F+15 DR was followed-up 1 to 2 times among 8 patients. The characteristics of DR image were analyzed. Hydronephrosis was classified into 5 grades on the base of DR. The score follow-up [= (hydronephrosis grading before surgery-hydronephrosis grading after surgery)/hydronephrosis grading before surgery] were divided into 5 groups: negative = worse; zero = unchanged; 1%-32%=satisfactory; 33%-65% = good; > 65% = perfect. Results The morphological change of urinary organs: Radioactivity residual occurred in all renal pelves and 40 calyxes(90. 9%) of the studied cases; 34 ureters were wholly dilatated(77. 3% ) , 15 were bilaterally by dilatated (68.2% ) , 5 ureters overlapped with bladder in imaging; 8 bladders did not fill, 1 was enlarged, 9 were diminished and some bladders had specifical change in imaging. The follow-up results: 2 kidneys were worse, 6 unchanged , 3 satisfactory, 3 good, and 1 perfect. Conclusion DR demonstrates characteristic morphological change of the upper urinary tract in neonates and infants with posterior urethral valve. It helps in diagnosis and treatment. DR is all-sided, accurate and practical in evaluating the follow-up results after surgery.更多还原