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Practical value of intravenous urography combined with add-on CT in diagnosina ureteral abnormalities

Chinese Medical Journal 2012年第7期125卷 1287-1291页

作者： HU Xiao-yun HU Chun-hong FANG Xiang-ming YAO Xuan-jun Alexander Lemer CHEN Hong-wei ZHU Zhong-ming Imaging Center First Affiliated Hospital of Soochow UniversitySuzhouJiangsu 215006China Imaging Center Wuxi People’s Hospital Affiliated to Nanjing Medical UniversityWuxiJiangsu 214023China

Background Intravenous urography （IVU） combined with add-on CT （IVU-CT） can help to provide more diagnostic information for determining the localization and nature of ureteral abnormalities with less irradiation dose. This study aimed to determine the value of IVU-CT for diagnosis of ureteral diseases, where IVU is insufficient to determine the diagnosis. Methods Two hundred and eighty patients underwent IVU for suspected ureteral disorders, which identified a definite diagnosis in 184 cases and was insufficient for definite diagnosis in 96 cases designated as indeterminate diagnosis. Subsequently 90 patients （six patients declined CT） with indeterminate diagnosis consented to undergo immediate or delayed helical CT scan. The CT data were transferred to the workstation for post-processing, and the cost and mean effective dose for each imaging method were calculated and compared indirectly. Results Of the 90 indeterminate diagnosis cases, diagnosis was determined in 86 cases by IVU-CT with a diagnostic accordance rate of 95.6%, while 184/280 （65.7%） had diagnosis determined by IVU alone. There was a significant difference between IVU and IVU-CT in the determination of the diagnosis of ureteral diseases （X2=36.4, P 〈0.05）. The cost of IVU equals to 1/8-1/9 of that for CT urography （CTU）, and the cost of IVU-CT is as much as 1/3 of CTU. CTU results in the highest mean effective dose, approximately nine times that for IVU and three times that for IVU-CT. Conclusion IVU-CT provides valuable information for the localization and diagnosis of ureteral abnormalities and may be considered as an efficient, cost-effective and low-dose diagnostic technique in this setting.

关键词： tomography ureteral disease urography diagnosis

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Magnetic resonance urography in the diagnosis of urinary tract obstruction after renal transplantation

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Chinese Medical Journal 2002年第4期115卷 540-542页

作者：李响韩志友王玮张愚高居忠北京朝阳医院泌尿外科北京100020

OBJECTIVE: To evaluate magnetic resonance urography (MRU) in the diagnosis of urinary tract obstruction after renal transplantation. METHODS: A total of 31 patients with suspected urinary tract obstruction after renal transplantation were examined, and the results were compared with those from surgery and B-ultrasound examination. RESULTS: The urinary tract after renal transplantation was clearly shown using MRU, and all patients were clearly diagnosed by MRU. Imaging results were consistent with those from surgery. CONCLUSIONS: MRU is suitable for detecting urinary tract obstruction after renal transplantation. It is a alternative method for IVP and CT in patients with renal function impairment and uremia.

关键词： Kidney Transplantation Humans Magnetic Resonance Imaging Ureteral Obstruction Urinary Tract urography

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Study of Role of Magnetic Resonance urography (MRU) and Comparison with Conventional Radiology in the Diagnosis of Complex Renal Anomalies: A Tertiary Care Centre Experience

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Open Journal of Urology 2012年第3期2卷 113-118页

作者： Priti Zade Sharad Khandelwal Milind Joshi Sandesh Parelkar Shyam Borwankar Opposite Bombay Hospital Indore India

Anatomical renal anomalies are one of the most commonly occurring renal anomalies. Most of these anomalies require series of investigations for the proper diagnosis. We tried to compare the results of conventional radiological investigations with magnetic resonance urography in the diagnosis of complex renal anomalies. Materials and methods: This was a prospective study done over a period of five years from 2006 to 2011. All the patients with suspected or diagnosed presence of renal anomalies were investigated by ultrasound (USG), Intravenous urography (IVU), micturating cystourethrogram (MCU), magnetic resonance urography (MRU), retrograde urethrography, cystogenitoscopy, renal scans as per the indication in the case. Results: Total sixty three patients were studied over the period. The most common complex renal anomaly diagnosed was duplex system and conventional radiological investigations were useful in the diagnosis of less than 50% patients. Female patients outnumbered male patients in having complex renal anomalies. MRU was diagnostic in most of the patients with such anomalies and excellent mode of investigation for functional and anatomical details. Conclusion: MRU is better than conventional radiological investigations in the diagnosis of complex renal anomalies.

关键词： Complex Renal Anomalies Conventional Radiology Magnetic Resonance urography

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IMAGING TECHNIQUES FOR THE DIAGNOSIS OF RENAL TUMORS

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Chinese Medical Sciences Journal 1990年第2期8卷 75-78页

作者：顾方六 Institute of Urology Beijing Medical UniversityBeijing

In recent *** imaging techniques,especially ultrasonography (US) and CTscanning,have been widely adopted in clinical practice,making early accurate diagnosisof renal tumors possible.A total of 452 cases of renal tumors have been admitted to theinstitute since 1951,of which 220 were seen from 1951 to 1979 and 232 in the past 9years (1980-1988).The frequency of renal parenchymal tumors was obviously higher in thelatter group,including asymptomatic renal carcinoma in 20.2% and hamartoma in 38.1%.All these were discovered on routine physical check-up by ultrasonography and/or CTscanning and would otherwise have gone undiagnosed on conventional ***-sonography and CT can also reveal the nature and the extent of the *** idea that“a renal tumor should be considered malignant unless pathologically proven otherwise”isno longer ***,general manifestations of renal carcinoma,such as elevatederythrocyte sedimentation rate (ESR),hypertension,malaise,anemia,fever and hypercalcemia,still deserve proper *** suggest that ultrasonography of both kidneys should bemandatory in routine physical check-up,as far as the urinary system is concerned,in orderto discover asymptomatic renal tumors.

关键词： ultrasonography CT scanning renal carcinoma urography

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MRI of the Bladder in Patients Suspected of Bladder Tumors

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Open Journal of Radiology 2014年第2期4卷 207-214页

作者： Karen Lind Gandrup Jorgen Nordling Henrik S.Thomsen Department of Diagnostic Radiology Copenhagen University Hospital HerlevCopenhagenDenmark Department of Urology Copenhagen University Hospital HerlevCopenhagenDenmark

Objective: To prospectively evaluate the use of MRI for the detecting of bladder tumors and the T- stage using T2W, T1W and diffusion-weighted images (DWI). Material and methods: Twenty-eight consecutive patients (21 men, 7 women;age range, 20 - 82 years;mean age, 62.8 years) suspected of bladder tumors underwent MRI, flexible cystoscopy and transurethral resection (TURB). The presence of bladder tumor was confirmed by histopathology in 21 patients;18 patients had pTa, one pT1 and two pT2. The images were reviewed by two uroradiologists. They assigned the presence of a bladder tumor and whether the tumor was non-muscle invasive (Ta and T1) or muscle- invasive (T2, T3 or T4). Results: Compared to the histopathological results, the accuracy for identifying a bladder tumor was 60.7% and 53.7% for reviewer A and B, respectively. The sensitivity and specificity were 66.7%/61.9% and 57.1%/42.9%. Positive predictive values were 82.6%/ 76.5%. The overall staging was correct in 47.6%/52.5%, but improved on stage-by-stage up to 50%/66.7%. The agreement between the reviewers was moderate in the detecting, staging and location of the tumor (Kappa = 0.47 - 0.57). Conclusion: A simple MRI using no contrast media, but DWI, cannot replace flexible cystoscopy in the detection of new or recurrent bladder tumors.

关键词： urography Diagnostic Imaging Hematuria Magnetic Resonance Imaging Cystoscopy

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Characteristics on diagnosis and treatment of renal tuberculosis

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外科研究与新技术 2003年第2期 118-119页

作者：龚宇 Dept Urol Southwest Hosp3rd Mil Med UnivChongqing 400038

Objective To study the new characteristics on diagnosis and treatment of renal tuberculosis ( RT). Methods Eighty-seven patients with renal tuberculosis were retrospectively reviewed; their diagnosis was established by standard microbiological and histological techniques. Results Atypical RT was diagnosed by various examinations, including urinary analysis, polymerase chain reaction of tuberculosis ( PCR-TB), ultrasonography, intravenous urography ( IVU), and computerized tomography (CT). Treatment consisted of antituberculous chemotherapy in all patients, in combination with nephrectomy (62. 5 %) or enterocytoplasty (4. 6%). Conclusion The differential diagnosis of RT should be emphasized, especially for atypical RT, provided a much more specific diagnosis in clinical suspicion of RT. IVU can not be regarded as a specific examination for RT. Computerised tomography (CT) can be used for early diagnosis of RT. Surgery for TR is still ablative. 5 refs.

关键词： tuberculosis intravenous atypical histological chemotherapy computerized urography emphasized urinary Surgery

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Psoas muscles vane with pedicle flap in the treatment of Nephroptosis 285 cases

Psoas muscles vane with pedicle flap in the treatment of Nep...

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第十五届全国泌尿外科学术会议

作者： Qiu Minxing, Xiong Guobing,Gong Baisheng,Wang Dong,Chen Zhaoxiang,Pan Cikang. (Department of Urology, the People’s Hospital of Sichuan Province, Chengdu ,China 10072)

Objective To study the clinical effects of treatment of nephroptosis with psoas muscles vane with pedicle flap. Methods The clinical data of 285 patients with nephroptosis from 1985 to 2006 were retrospectively analyzed. Nephroptosis were proved by plain abdominal radiograph、intravenous pyelography(IVU)or retrograde pyelography(RP)in all patients preoperative. Nephropexia with psoas muscles vane with pedicle flap were performed in all patients. Results There are 461 kidneys of nephroptosis in 285 patients, and 425 kidneys received nephropexia with psoas muscles vane with pedicle flap(The surplus 36 kidneys do not need surgical procedures). The operative time was 40-85 min(mean 60.5min),the time of lying in bed post-operative was 6-12 d(mean 7.22d)。IVU 、RP or CT results of 261 cases of 285 patients showed no recurrence or severe operation complications during 12 months-10 years follow-up(mean 6.2 years). Conclusion Nephropexia with psoas muscles vane with pedicle flap is a safe、effective and economic method.

关键词： Nephroptosis Psoas muscles vane urography Urologic Surgical Procedures

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经皮肾镜碎石术致结肠损伤意外拔管后多处脓肿形成一例报告

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中华腔镜泌尿外科杂志（电子版） 2017年第4期11卷 61-62页

作者：刘清学高飞彭洪凌思果攀钢集团总医院泌尿外科四川攀枝花617023

经皮肾镜碎石术导致结肠损伤是一种罕见而严重的并发症,虽然近年来有一些报道,但对于在确诊结肠损伤前就拔除了肾造瘘管的处理非常棘手。攀钢集团总医院发生1例,为引起重视并加以预防,结合相关文献复习,现报告如下。

关键词：结肠损伤经皮肾镜碎石术肾造瘘管排泄性尿路造影右肾结石意外拔管攀钢集团 intravenous 结肠穿孔 urography

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Multi-modality imaging review of congenital abnormalities of kidney and upper urinary tract

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World Journal of Radiology 2016年第2期8卷 132-141页

作者： Subramaniyan Ramanathan Devendra Kumar Maneesh Khanna Mahmoud Al Heidous Adnan Sheikh Vivek Virmani Yegu Palaniappan Department of Clinical Imaging Al-Wakra Hospital Hamad Medical Corporation Department of Medical Imaging the Ottawa Hospital Department of Radiology Dr.Everett Chalmers Hospital Shree Meenakshi Multi Specialty Hospital

Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number(agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography(US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography(CT) and magnetic resonance imaging(MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.

关键词： Congenital abnormalities Kidney Urinary tract Multi cystic dysplastic Kidneys Pelvi ureteric junction obstruction Computed tomography urography Congenital abnormalities of the Kidney and urinary tract End stage renal disease Horse shoe Kidneys

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