異位性輸尿管囊腫之超音波探查

Ultrasonic Detection of Ectopic Ureterocele

謝從賓(Chung-Pin Sheih) ； 李瑤華(Yiu-Hwa Li) ； 廖揚振(Yang-Jann Liao)

《Acta Paediatrica Sinica》 33卷3期 (1992/06) Pp. 181-190

摘要

四年來我們共有十位雙套性腎臟合併異位性輸尿管囊腫，其中一位為兩側性囊腫，其餘為單側性囊腫。八位女童、二位男童。年齡從新生充到十五歲。其臨床症狀，五位病人有尿路感染、一位滴尿、另四位沒有症狀。其中六位接受外科手術，四位追蹤觀察。與異位性輸尿管囊腫相連之上端腎臟，因功能不佳或幾無功能，作靜脈注入泌尿系攝影時，上端腎臟及其輸尿管顯影不良或不能顯影，造成診斷上的困難。超音波檢查不依賴腎功能，對這種病變的探查，效果極佳。這十位病人接受檢查時，可發現腎臟上端部分的腎盂擴張，與擴張的輸尿管相聯，輸尿管並往下延伸，到膀胱後方，可見擴張之輸尿管注入膀胱內的囊腫。由於膀胱內都可以見到囊腫，而呈現出〝囊腫中的囊腫〞。十位病人中有五位上端部分仍存有腎實質，評估上端腎實質的厚度，可作為外科手術，是否切除的參考。又其中二位，上端腎臟之集尿系統內有膿瘍，由超音波檢查得知。故超音波檢查是發現、評估、診斷，及追蹤此種病變最佳方法之一。

並列摘要

Ten cases of duplex kidney with ectopic ureterocele were detected by ultrasound in the recent four years. There were eight girls and two boys. One case was found to have bilateral ectopic ureterocele, the others were unilateral. Urinary tract infection was found in five cases, urinary dribbling was told in one case, and the other four cases were asymptomatic. The age distribution ranged from newborn to 15 years. Six cases received surgery, and the other four cases were followup at O.P.D. In these cases, the sonography could identify the hydronephrotic nature of the upper pole moiety. Dilatation of the upper pole ureter could be demonstrated. A sonolucent intravesical cystic mass also could be outlined. In this series, five cases with residual parenchyma were assessed by ultrasonography, and two cases with pus formation in the upper pole collecting system were detected. On intravenous urogram, the affected upper pole moiety was not or poorly visualized in these cases, thus produced some diagnotic challenges. Ultrasonic examination is an excellent method to identify a fluid- filled cystic structure, and can provide a simple and non-invasive technique for confirmation of ectopic ureterocele, which is independent of renal function. Therefore, it has become an important modality in the detection, diagnosis and followup of this anomaly.

並列關鍵字

renal duplication ； ectopic ureterocele ； ultrasonography