【摘要】 目的探讨成人肾盂输尿管交界处梗阻性病变(AUPJOD)的临床病理学特点与超声诊断的临床价值。方法回顾性分析由超声检查并经手术和病理证实的94例AUPJOD患者的临床资料。采用膀胱高度充盈状态下腹部超声检查法,分析AUPJOD的超声图像特征与临床病理学之间的关系。结果本组94例患者共102侧AUPJOD中,右侧51例,左侧35例,双侧8例。临床病理学中肾盂输尿管交界处(UPJ)结石36例(38侧),单纯性UPJ狭窄16例(17侧),术后UPJ狭窄8例,UPJ癌8例,结缔组织纤维条索压迫UPJ4例(6侧),UPJ周围转移癌及囊肿压迫UPJ各4例,输尿管高位附着和肾结核各3例、迷走血管压迫UPJ2例(3侧)、UPJ息肉2例、UPJ瓣膜2例(3侧)、UPJ迂曲2例(3侧)。AUPJOD的超声特征为肾窦不同程度的分离扩张,UPJ呈截断性改变,输尿管无扩张。肾积水轻度37侧(36.27%)、中度42侧(41.77%)和重度23侧(22.55%)。超声对AUPJOD的定位诊断与手术符合率为98.04%(100/102),病因诊断与临床病理学符合率为82.35%(84/102)。结论 AUPJOD的临床病理学特点是以结石、狭窄和肿瘤等病变导致不同程度的肾积水和肾功能损害。超声对AUPJOD的病因和定位具有重要的诊断价值,但对UPJ迂曲、瓣膜、迷走血管和纤维条索压迫以及UPJ息肉等引起的AUPJOD,超声不能明确诊断,需结合病史和临床表现与影像学检查综合分析判断。更多还原

【Abstract】 Objective To explore the clinical value of the clinical pathology characteristic and ultrasonic diagnosis of ureter pelvic junction obstructive diseases(AUPJOD) in adult.Methods The clinical data of 94 cases of AUPJOD that underwent ultrasound examination and confirmed by surgery and pathology were retrospectively analyzed.The ultrasonic image characteristics of AUPJOD and the correlation with the clinical pathology were analyzed.Results Among 94 patients with 102 AUPJOD,51 cases were right side,35 cases were left side,8 cases were bilateral sides.Clinical pathology of renal pelvis ureteral calculi junction(UPJ) were 36 cases(38 sides),simple UPJ stricture were 16 cases(17 sides),postoperative UPJ stricture were 8 cases,UPJ carcinoma were 8 cases,connective tissue fibers cable oppression UPJ were 4 cases(6 sides),UPJ surrounding metastatic carcinoma and cyst compression UPJ each were 4 cases,ureteral high adhesion and renal tuberculosis were 3 cases,vagus vascular compression UPJ were 2 cases(3 sides),UPJ polyp were 2 cases,UPJ valve were 2 cases(3 sides),UPJ circuity were 2 cases(3 sides).The sonographic features of AUPJOD were different degrees of separation and expansion of renal sinus,UPJ was truncation change,ureteral no expansion.Mild hydronephrosis were 37 sides(36.27%),moderately were 42 sides(41.77%) and severe were 23 sides(22.55%).The coincidence rate of positioning diagnosis of AUPJOD by ultrasound and surgery was 98.04%(100/102),the coincidence rate of etiology diagnosis and clinical pathology was 82.35%(84/102).Conclusions The clinical pathology charateristic of AUPJOD is the stone,a narrow and tumor lesion lead to different degrees of hydronephrosis and kidney damage.Ultrasound has important diagnostic value for the etiology and location of AUPJOD,but can not clearly diagnose the AUPJOD caused by UPJ tortuous,valve,vagus blood vessels,fiber cords and UPJ polyps,it need to combining with the clinical history,clinical manifestations and imaging examination.更多还原