Elwagdy Salah, Ghoneim Sayed, Moussa Sayed, Ewis Ibrahim
Uroradiology, Azhar University, 133, Shubra st, Cairo 11242, Egypt.
World J Urol. 2008 Jun;26(3):263-74. doi: 10.1007/s00345-008-0241-8. Epub 2008 Mar 6.
To prospectively assess ureteric obstructive uropathy using three-dimensional ultrasound (3D US) methods when the etiology of ureteral obstruction was proved difficult to evaluate with two-dimensional ultrasound (2D US) and plain radiography.
The study had the local Ethics Committee approval. All patients gave informed consent. 318 patients: 219 men and 99 women (including 16 pregnant women) were selected within a 3-year period for 3D US based on clinical presentation, two dimensional ultrasound (2D US) results and preliminary plain radiography except for pregnant women. 3D US was performed on all patients. 301 patients had further excretory urogram before intervention decisions.
The study showed a high accuracy of detection of different levels of ureteric calcular obstruction; 99.1% in men and 96.7% in women. 3D XI technology proved more efficient in stone count (88.9%) than sectional planes and rendering method altogether (55.6%). The success rate of identifying obstructive uropathy due to inflammatory variants showed a perfect diagnostic value of 100%. Similar percentages could be obtained in cases secondary to neoplastic infiltration or permeation of the ureters. Cases compared with excretory urography revealed close correlation with 3D US and superiority of the latter when renal function physiologically altered in some cases of calcular obstructive uropathy.
The 3D US methods in case of obstructive uropathy have proved to be useful as an easy, mobile and non-invasive diagnostic tool, improving 2D US diagnostic utility.
当二维超声（2D US）和平片难以评估输尿管梗阻病因时，前瞻性地使用三维超声（3D US）方法评估输尿管梗阻性尿路病。
本研究获得当地伦理委员会批准。所有患者均签署知情同意书。基于临床表现、二维超声（2D US）结果及初步平片（孕妇除外），在3年期间内选取318例患者（219例男性和99例女性，包括16例孕妇）进行三维超声检查。所有患者均接受了三维超声检查。301例患者在做出干预决定前进一步接受了排泄性尿路造影。
研究表明，三维超声对不同程度输尿管结石梗阻的检测准确率较高；男性为99.1%，女性为96.7%。3D XI技术在结石计数方面（88.9%）比断层平面和渲染方法（55.6%）更有效。识别炎性病变所致梗阻性尿路病的成功率显示出完美的诊断价值，为100%。输尿管肿瘤浸润或侵犯继发的病例也能获得相似的百分比。与排泄性尿路造影相比，在一些结石梗阻性尿路病导致肾功能发生生理性改变的病例中，三维超声与之密切相关且具有优势。
对于梗阻性尿路病，三维超声方法已被证明是一种有用的、简便、可移动且无创的诊断工具，提高了二维超声的诊断效用。
