Wolf J S, Siegel C L, Brink J A, Clayman R V
Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
J Endourol. 1996 Apr;10(2):93-104. doi: 10.1089/end.1996.10.93.
The three goals of imaging for ureteropelvic junction (UPJ) obstruction are to determine the presence and degree of renal obstruction, to assess renal function, and to determine the cause of the problem. The diagnostic techniques are intravenous urography, which is unreliable; ultrasonography, with the addition of pulsed Doppler technology; diuretic scintigraphy; and pressure-flow studies (Whitaker test), which is the only direct clinical test of renal outflow resistance. Voiding cystography, retrograde ureteropyelography, and CT have utility in some patients. In determining the cause of obstruction, the patient often is evaluated for crossing vessels using angiography, endoluminal ultrasonography, or spiral CT. It is not possible to formulate a single algorithm for radiographic evaluation of suspected UPJ obstruction, but in the average adult patient, urography and diuretic scintigraphy are sufficient.
肾盂输尿管连接处（UPJ）梗阻的影像学检查有三个目的：确定肾梗阻的存在及程度、评估肾功能以及确定问题的病因。诊断技术包括可靠性欠佳的静脉肾盂造影；添加了脉冲多普勒技术的超声检查；利尿肾图；以及压力-流量研究（惠特克试验），这是唯一直接检测肾流出阻力的临床检查。排尿性膀胱造影、逆行肾盂造影和CT对部分患者有用。在确定梗阻原因时，常通过血管造影、腔内超声或螺旋CT对患者进行交叉血管评估。对于疑似UPJ梗阻的影像学评估，无法制定单一的算法，但对于一般成年患者，肾盂造影和利尿肾图就足够了。
