Philipp K
Wien Klin Wochenschr Suppl. 1982;135:1-25.
A new method to determine ureteral motility by means of radioisotopes is presented. After administration of 99m-Tc-MDP or 99m-Tc-DTPA urine transport within the ureter is documented by functional way-time-matrices. The special resolution results of a series of 7 to 12 regions of interest covering the ureter out of which the information about its motility is extracted from a series of 300 to 480 single pictures. The time resolution is 1 to 2.5 seconds. The observation period varies between 5 and 20 minutes. Urine transport is outlined as an declined stripe in the matrix. Retroperistaltic waves or dyskinesies can also be detected with this method. 31 patients in whom radical surgery was performed for carcinoma of the cervix were examined by the described functional ureter test. The results show that changes in ureteral function like frequency or quality or even retroperistaltic contractions of the ureter can be observed by the urokinetogram, changes which can be traced neither by isotope renogram nor by intervenous pyelography. Similar observations could be made in 10 patients treated by radiotherapy. In 26 patients the influence of sympathico- and parasympathicomimetic agents on the ureteral motility was studied. The results show that an increase of contraction frequency can be obtained by alpha- and betamimetics and also by cholinesterase inhibitors. These results which are in consistance with the available literature will be analysed and discussed in detail. The urokinetogram opens new possibilities to get insights into the physiology of urine transport and is therefore of great interest as an addition to radiologic and urodynamic methods.
本文介绍了一种通过放射性同位素测定输尿管蠕动的新方法。在给予99m-Tc-MDP或99m-Tc-DTPA后,通过功能时间矩阵记录输尿管内的尿液输送情况。从覆盖输尿管的一系列7至12个感兴趣区域的特殊分辨率结果中,从一系列300至480张单张图片中提取有关其蠕动的信息。时间分辨率为1至2.5秒。观察期为5至20分钟。尿液输送在矩阵中表现为一条下降的条纹。用这种方法也可以检测到逆行蠕动波或运动障碍。对31例行宫颈癌根治术的患者进行了上述功能性输尿管试验检查。结果表明,通过尿动力学图可以观察到输尿管功能的变化,如频率、质量甚至输尿管的逆行收缩,而同位素肾图和静脉肾盂造影均无法检测到这些变化。对10例接受放射治疗的患者也进行了类似的观察。对26例患者研究了拟交感神经药和拟副交感神经药对输尿管蠕动的影响。结果表明,α和β激动剂以及胆碱酯酶抑制剂均可使收缩频率增加。这些与现有文献一致的结果将进行详细分析和讨论。尿动力学图为深入了解尿液输送生理学开辟了新的可能性,因此作为放射学和尿动力学方法的补充具有重要意义。