Cantoro Daniele, Galosi Andrea Benedetto, Conti Alessandro, Muzzonigro Giovanni
Institute of Urology, Polytechnic University of Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
Arch Ital Urol Androl. 2010 Dec;82(4):211-4.
To evaluate the efficacy of transrectal or transvaginal Endocavitary Ultrasound (EU) to depict the juxtavesical and the uretero-vesical junction of the distal ureter.
We retrospectively examined a series of 80 patients with a variety of urological conditions affecting the distal ureter EU was performed with a 6-10 MHz transrectal/vaginal end-fire probe. In all cases the length of visible ureter was measured. The series included benign and malignant affections as follows: 68 cases of distal ureteral stones and 12 malignancies (10 transitional cell carcinomas, 1 prostate cancer, 1 gastrointestinal stromal tumor). Gray scale and Color Doppler findings were anayzed and images were electronically stored. Every patient also undwent a transabdominal sonography. Definitive diagnosis was made with standard radiological imaging. In 4 patients we performed echo-guided endocavitary guided biopsies to obtain an histological diagnosis of ureteral solid lesions when transurethral biopsies were not feasible or negative.
Length of visible ureter was 4 cm (SD 2.1). Ureteral stones were depicted in 80% of cases, however false negative were related to a stone localization above the last 4 cm of the visible distal ureter. The transabdominal approach depicted ureteral stones in 58% of cases. EU showed all the solid lesions located in the last 4 centimeters. Transabdominal approach showed a ureteral mass only in half of the cases. EU with Color Doppler (EUCD) was useful to evaluate the ureteral jet (presence or absence) and changes in the vasculature of solid lesions. Neither body habits, nor bladder fullness affected the reliability of the technique.
Our study shows that EU with end fire probe is a safe, minimally invasive and low cost technique for the investigation of pathological processes involving the lower part of the distal ureter.
评估经直肠或经阴道腔内超声（EU）描绘膀胱旁及输尿管膀胱连接部远端输尿管的效能。
我们回顾性研究了一系列80例患有影响远端输尿管的各种泌尿系统疾病的患者。使用6-10MHz经直肠/阴道端射探头进行EU检查。在所有病例中，测量可见输尿管的长度。该系列包括良性和恶性病变，如下：68例远端输尿管结石和12例恶性肿瘤（10例移行细胞癌、1例前列腺癌、1例胃肠道间质瘤）。分析灰阶和彩色多普勒检查结果并将图像电子存储。每位患者还接受了经腹超声检查。通过标准放射学成像做出明确诊断。在4例患者中，当经尿道活检不可行或为阴性时，我们进行了超声引导下腔内活检以获得输尿管实性病变的组织学诊断。
可见输尿管长度为4cm（标准差2.1）。80%的病例中描绘出输尿管结石，然而假阴性与结石位于可见远端输尿管最后4cm以上的位置有关。经腹途径在58%的病例中描绘出输尿管结石。EU显示了所有位于最后4厘米的实性病变。经腹途径仅在一半的病例中显示出输尿管肿块。彩色多普勒腔内超声（EUCD）有助于评估输尿管喷流（有无）及实性病变血管系统的变化。体型和膀胱充盈程度均不影响该技术的可靠性。
我们的研究表明，使用端射探头的EU是一种安全、微创且低成本的技术，用于研究涉及远端输尿管下部的病理过程。
