Sakuma T, Ogawa O
Department of Urology, Nobeoka Clinic.
Nihon Hinyokika Gakkai Zasshi. 1998 Apr;89(4):468-76. doi: 10.5980/jpnjurol1989.89.468.
We performed renal ultrasonographic screening on 3799 healthy 3-month-old infants, who showed up for the routine health check up in Nobeoka City, for congenital malformations of the urinary tract.
Urinary tract disorders were suspected in 139 (3.7%). Almost all ultrasonographic abnormalities of these were dissociation of CEC (Central Echo Complex). Thirty-three (24.4%) of the 135, which was 0.9% of the original 3799, were diagnosed as having significant congenital anomalies in urinary tract, such as vesicoureteral reflux (VUR) in 17, hydronephrosis in 10, unilateral renal agenesis in 2, unilateral small kidney in 2 and each case of horseshoe kidney, simple ureterocele, ectopic ureterocele, megaureter and mild dilated ureter. Minor or mild renal pelvis enlargement without the dilatation of calyx was found in 78 cases. Fifty-three of the 78 were followed more than 3 months, and complete or partial reduction of the pelvic enlargement was noted in 39 (74%), while enlarged pelvis remained unchanged in 14. There was no progressive hydronephrosis among these patients during the follow-up. Urinary tract infections were found in 6 cases (5 in VUR and 1 in ectopic ureterocele). Eleven ureters in 9 children of VUR (44%) were cured spontaneously (follow-up period: 3 months-6 months and 2 years). Surgical correction was required in 6 cases, antireflux surgery for VUR in 4, heminephroureterectomy for ectopic ureterocele in 1 and endoscopic incision of ureterocele for simple ureterocele in 1.
Our result indicate that infant ultrasonographic screening is a useful and valuable method of detecting urinary tract malformations.
我们对3799名健康的3个月大婴儿进行了肾脏超声检查，这些婴儿在延冈市进行常规健康检查，以筛查泌尿系统先天性畸形。
139例（3.7%）疑似泌尿系统疾病。这些病例中几乎所有超声异常均为中央回声复合体分离。135例中的33例（占最初3799例的0.9%）被诊断为患有严重的泌尿系统先天性异常，如17例膀胱输尿管反流（VUR）、10例肾积水、2例单侧肾缺如、2例单侧小肾以及马蹄肾、单纯输尿管囊肿、异位输尿管囊肿、巨输尿管和轻度输尿管扩张各1例。78例发现有轻微或轻度肾盂扩大但无肾盏扩张。78例中的53例随访超过3个月，39例（74%）肾盂扩大完全或部分减轻，14例肾盂扩大保持不变。随访期间这些患者均无进行性肾积水。发现6例泌尿系统感染（VUR患者5例，异位输尿管囊肿患者1例）。9例VUR患儿中的11条输尿管（44%）自发治愈（随访期：3个月至6个月以及2年）。6例需要手术矫正，4例因VUR行抗反流手术，1例因异位输尿管囊肿行半肾输尿管切除术，1例因单纯输尿管囊肿行输尿管囊肿内镜切开术。
我们的结果表明，婴儿超声筛查是检测泌尿系统畸形的一种有用且有价值的方法。
