Kunin M, Goodwin W E
Department of Radiology, Harbor-UCLA Medical Center, Torrance.
Br J Urol. 1990 Nov;66(5):471-4. doi: 10.1111/j.1464-410x.1990.tb14990.x.
Among the causes of constricted ureter is benign or malignant encasement. The diagnosis of ureteric encasement is frequently overlooked, even by well informed clinicians and radiologists. The most common benign cause is retroperitoneal fibrosis and the most frequent malignant causes are extension from an adjacent primary tumour, true metastases to the ureter and lymphoma. Lack of recognition of the process may lead to mistaken diagnosis of an inflammatory stricture or infiltrating transitional cell tumour, with resultant inappropriate management. A sign which appears to be almost specific for encasement, the bullet and bodkin configuration, is described here. Newer imaging modalities such as computed tomography and ultrasound, while helpful, are probably less sensitive and less specific than the retrograde ureterogram because a detectable mass is not always present.
输尿管狭窄的病因包括良性或恶性包绕。输尿管包绕的诊断常常被忽视，即使是见多识广的临床医生和放射科医生也不例外。最常见的良性病因是腹膜后纤维化，最常见的恶性病因是邻近原发性肿瘤的蔓延、输尿管的真正转移瘤和淋巴瘤。对该病情缺乏认识可能导致误诊为炎性狭窄或浸润性移行细胞肿瘤，从而导致不恰当的治疗。本文描述了一种几乎对包绕具有特异性的征象，即子弹头和探针样形态。计算机断层扫描和超声等新型成像方式虽然有帮助，但可能不如逆行输尿管造影敏感和特异，因为并非总是能检测到肿块。
