Karmazyn B, Zerin J M
Department of Radiology, Indiana University Medical Center, Indianapolis 46202-5200, USA.
Radiology. 1997 Apr;203(1):223-6. doi: 10.1148/radiology.203.1.9122397.
To determine the nature and frequency of associated structural abnormalities of the lower urinary tract in children with multicystic dysplastic kidney.
The authors reviewed imaging findings from studies in 59 children with unilateral multicystic dysplastic kidney. All patients had undergone renal ultrasonography (US), renal scintigraphy, and voiding cystourethrography. The diagnosis was based on characteristic imaging findings (echogenic, cystic kidney at US that did not function at scintigraphy).
Nineteen (32%) patients had one or more abnormalities of the lower urinary tract. Vesicoureteral reflux was most common (15 patients). Reflux occurred into the contralateral ureter in 12 patients and the ipsilateral atretic ureter in five (two had bilateral reflux). Four patients had ectopic ureters: Three cases were ipsilateral and inserted into the prostatic urethra (two cases, both with reflux) or into the seminal vesicle (one case); one case was contralateral and inserted into the bladder neck. Four patients had an ipsilateral obstructed single-system ureterocele. Four patients had bladder diverticula. Other abnormalities included hypospadias, opacification of a small utricle (not in the patient with hypospadias), ejaculatory duct reflux, internal urachal sinus, and lipomeningocele with a neurogenic bladder.
Abnormalities of the lower urinary tract are common in children with unilateral multicystic dysplastic kidney. Voiding cystourethrography should be performed routinely in this population.
确定多囊性发育不良肾患儿下尿路相关结构异常的性质和发生率。
作者回顾了59例单侧多囊性发育不良肾患儿的影像学检查结果。所有患者均接受了肾脏超声（US）、肾闪烁显像和排尿性膀胱尿道造影。诊断基于特征性影像学表现（超声显示为高回声、囊性肾脏，闪烁显像时无功能）。
19例（32%）患者存在下尿路一处或多处异常。膀胱输尿管反流最为常见（15例患者）。12例患者反流至对侧输尿管，5例反流至同侧闭锁输尿管（2例为双侧反流）。4例患者有异位输尿管：3例为同侧，分别开口于前列腺尿道（2例，均伴有反流）或精囊（1例）；1例为对侧，开口于膀胱颈。4例患者有同侧梗阻性单系统输尿管囊肿。4例患者有膀胱憩室。其他异常包括尿道下裂、小囊状结构浑浊（尿道下裂患者未出现）、射精管反流、脐尿管窦、脂肪瘤样脊膜膨出合并神经源性膀胱。
单侧多囊性发育不良肾患儿下尿路异常较为常见。该类患儿应常规进行排尿性膀胱尿道造影。
