【摘要】 目的：探讨ＭＲＵ在小儿泌尿道畸形疑难病例诊断中的应用。材料和方法：用重Ｔ２加权ＦＳＥ序列，脂肪抑制技术对１７例４天～１４岁、ＩＶＵ未显影或（和）ＩＶＵ，ＵＳ诊断不明的病例作ＭＲＵ检查。结果：（１）能作定性诊断的疑难病例９例，包括：多囊性发育不良肾、少见类型的异位输尿管囊肿以及重度积水的巨输尿管各２例；马蹄肾并发输尿管结石与积水、特大型先天性膀胱Ｈｕｔｃｈ 憩室以及脐尿管囊肿各１例。（２）能准确定位并有肾脏多囊性疾病等鉴别清楚、满足手术需要者５例，皆为盂管交界部梗阻。（３）显示两侧重度尿路积水、提示需作其他相应检查以确定病因者３例，包括：后尿道瓣膜２例，神经原性膀胱１例。结论：ＭＲＵ是无创性确诊小儿泌尿道畸形疑难病例的理想手段，必须强调在全面对比分析ＭＩＰ图像、原始图像、Ｔ２加权轴位像以及在监视器荧屏上三维旋转时的所见后进行综合诊断。更多还原

【Abstract】 Purpose: To evaluate the role of MR urography (MRU) in the diagnosis of difficult cases with congenital malformation of urinary tract in children. Materials and Methods: MRU was performed in 17 pediatric cases (4 days to 14 years old) with congenital malformation of the urinary tract from August 1997 to Jane 1999, in which diagnosis cannot be made by either intravenous urography (IVU) or utrasonography (including none visible urinary tract in IVU) .Heavy T2 weighed FSE sequence with fat saturation was used. Results: (1) Definitive diagnosis with characteristic findings had been made in 9cases (53% ) including multicystic dyplastic kidney (2 cases) , rare type ectopic ureterocele (2 cases) , severe megaureter (2 cases), horse shoe kidney complicated with hydronephrosis due to left ureteric calculus (1 cases) , huge urinary bladder diverticulum (l case), and urachal cyst (1 case). (2)The diagnosis of 5 cases (29% ) with pyeloureteric junction stenosis all met the surgical requirements - localization of the urinary tract obstruction and exclusion of the renal multicystic diseases. (3) Three cases (18% ) of bilateral severe hydronephrosis, including posterior urethral valve (2 cases) and neurogenic bladder (1 case) 3 only had a suggestive diagnosis, and further clarification with other modality was in need. Conclusion: MRU is an ideal modality for the diagnosis of difficult podiatric cases with congenital malformation of the urinary tract. The value of source images is emphasized, which should be used in combination with MIP images.更多还原