Hassan Radhiana, Aziz Azian Abd, Mohamed Siti Kamariah Che
Department of Radiology, Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, 25200 Kuantan, Pahang, Malaysia.
Malays J Med Sci. 2011 Oct;18(4):84-7.
Retrocaval ureter is a rare cause of hydronephrosis. Its rarity and non-specific presentation pose a challenge to surgeons and radiologists in making the correct diagnosis. Differentiation from other causes of urinary tract obstruction, especially the more common urolithiasis, is important for successful surgical management. Current practice has seen multislice computed tomography (MSCT) rapidly replaces intravenous urography (IVU) in the assessment of patients with hydronephrosis due to suspected urolithiasis, especially ureterolithiasis. However, MSCT, without adequate opacification of the entire ureter, may allow the physician to overlook a retrocaval ureter as the cause of hydronephrosis. High-resolution IVU images can demonstrate the typical appearance that leads to the accurate diagnosis of a retrocaval ureter. We reported a case that illustrates this scenario and highlights the importance of IVU in the assessment of a complex congenital disorder involving the urinary tract.
腔静脉后输尿管是肾积水的一种罕见病因。其罕见性及非特异性表现给外科医生和放射科医生做出正确诊断带来了挑战。与其他尿路梗阻病因，尤其是更常见的尿路结石相鉴别，对于成功的手术治疗很重要。目前的做法是，在评估因疑似尿路结石，尤其是输尿管结石导致肾积水的患者时，多层螺旋计算机断层扫描（MSCT）迅速取代了静脉肾盂造影（IVU）。然而，如果整个输尿管没有足够的造影剂充盈，MSCT可能会使医生忽略腔静脉后输尿管作为肾积水病因。高分辨率IVU图像能够显示出典型表现，从而准确诊断腔静脉后输尿管。我们报告了一个病例，该病例说明了这种情况，并强调了IVU在评估涉及尿路的复杂先天性疾病中的重要性。
