Catalano O, De Sena G, Nunziata A
Servizio di Radiologia, Ospedale S. Maria delle Grazie, ASL Na/2, Pozzuoli, NA.
Radiol Med. 1998 Jun;95(6):614-7.
To report our personal experience with color Doppler ultrasound (US) in the study of the ureterovesical jet in patients with recent renal colic.
First, the jet was studied in 10 healthy subjects and then 42 consecutive patients with urinary colic were submitted to plain radiography, which was sometimes integrated with conventional renal tomography, and real time US to detect the stone and to study the urinary tract above. Then, color Doppler function studies were carried out with transverse scans at the trigone and with the scan plane rotated on the ureterovesical junction. Retrospectively, the jet frequency, velocity, duration, volume, direction and interval were analyzed. Finally, all patients were examined with excretory urography.
The jet had an anteromedial direction and exceeded the midline in the controls, with a peak velocity of 20-30 cm/s, mean duration of 15 s, mean frequency of 4-5 min and interjet interval 2-150 s. The jet was abnormal in the obstruction side in all renal colic patients; it was slow, continuous, decreased in volume and intensity, and prolonged in 26 patients--20 of them had incomplete lumbo-iliac ureteral obstruction and 6 pyeloureteral junction stones. The jet was diverted from its orientation in 7 subjects with intramural stones. There was no jet in 9 patients and urography demonstrated complete urinary obstruction--4 at the pyeloureteral junction and 5 at the lumbo-iliac ureter.
Color Doppler US of the ureteral jet is a valuable tool in urinary colics because it yields in real time more pieces of functional information than radiography and B-mode US and also demonstrates the grade of urinary obstruction.
报告我们运用彩色多普勒超声（US）研究近期有肾绞痛患者输尿管膀胱喷射的个人经验。
首先，对10名健康受试者的喷射情况进行研究，然后对42例连续的尿绞痛患者进行腹部平片检查，有时还结合传统肾脏体层摄影以及实时超声检查，以检测结石并研究上方的尿路情况。接着，在膀胱三角区进行横向扫描，并使扫描平面围绕输尿管膀胱连接处旋转，进行彩色多普勒功能研究。回顾性分析喷射频率、速度、持续时间、容量、方向和间隔。最后，所有患者均接受排泄性尿路造影检查。
在对照组中，喷射方向为前内侧且超过中线，峰值速度为20 - 30厘米/秒，平均持续时间为15秒，平均频率为4 - 5次/分钟，喷射间隔为2 - 150秒。在所有肾绞痛患者中，梗阻侧的喷射均异常；喷射缓慢、持续，容量和强度降低，26例患者的喷射时间延长——其中20例为腰髂部输尿管不完全梗阻，6例为肾盂输尿管连接处结石。7例有壁内结石的患者其喷射方向发生改变。9例患者无喷射，尿路造影显示完全尿路梗阻——4例在肾盂输尿管连接处，5例在腰髂部输尿管。
输尿管喷射的彩色多普勒超声是尿绞痛诊断中的一项有价值的工具，因为它能实时提供比放射摄影和B型超声更多的功能信息，还能显示尿路梗阻的程度。
