McDaniel Benjamin B, Jones Richard A, Scherz Hal, Kirsch Andrew J, Little Stephen B, Grattan-Smith J Damien
Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA.
AJR Am J Roentgenol. 2005 Dec;185(6):1608-14. doi: 10.2214/AJR.04.1574.
The purpose of our study was to retrospectively review our experience using MR urography in the diagnosis of ureteropelvic junction (UPJ) obstruction in children.
Sixty-one studies were performed in 50 children with hydronephrosis but without hydroureter. Anatomic criteria assessed included degree of hydronephrosis, morphology of the renal pelvis, atrophy of medulla, swirling contrast material, fluid levels, and the presence of fetal folds and crossing vessels. Functional criteria included renal transit time, differential renal function, and time-intensity curves when available.
Thirty-one kidneys were classified as obstructed, 15 as equivocal, and 15 as nonobstructed. Obstructed systems had more marked hydronephrosis, more extensive medullary atrophy, more fluid levels, and more swirling contrast material. Fetal folds were seen in only the equivocal and nonobstructed groups. Crossing vessels were seen in all groups. Obstructed systems also showed greater functional derangement, decreased split renal function, and abnormal time-intensity curves.
MR urography provides both excellent anatomic and functional information in children with UPJ obstruction in a single test that does not use ionizing radiation. MR urography may lead to greater understanding of the pathophysiology of UPJ obstruction.
我们研究的目的是回顾性分析我们使用磁共振尿路造影（MRU）诊断儿童肾盂输尿管连接部（UPJ）梗阻的经验。
对50例肾积水但无输尿管积水的儿童进行了61次检查。评估的解剖学标准包括肾积水程度、肾盂形态、髓质萎缩、造影剂漩涡、液平，以及胎儿型褶皱和交叉血管的存在情况。功能标准包括肾转运时间、分肾功能，以及有条件时的时间-强度曲线。
31个肾脏被分类为梗阻性，15个为可疑性，15个为非梗阻性。梗阻性系统肾积水更明显，髓质萎缩更广泛，液平更多，造影剂漩涡更多。仅在可疑性和非梗阻性组中可见胎儿型褶皱。所有组中均可见交叉血管。梗阻性系统还表现出更大的功能紊乱、分肾功能降低和异常的时间-强度曲线。
MRU在一项不使用电离辐射的检查中为患有UPJ梗阻的儿童提供了出色的解剖学和功能信息。MRU可能有助于更深入地了解UPJ梗阻的病理生理学。
