Новости | Магазин | Журналы | Контакты | Правила | Доставка | |
Вход Регистрация |
Представлены результаты обследования 637 больных с почечной коликой, причиной которой был уретеролитиаз. Всем больным были выполнены ультразвуковое и КТ исследования. 341 больному произвели рентгенологическое исследование, в том числе 77 из них – выделительную урографию. На основании полученных данных детально описаны компьютерно-томографические, ультразвуковые и рентгенологические признаки уретеролитиаза и мочеточниковой обструкции. КТ позволяет диагносцировать при уретеролитиазе повышение давления в мочевых путях в виде пиелокаликоэктазии и уретероэктазии, отек почечной паренхимы в виде увеличения почки, нечеткости ее контуров и снижения денситометрических показателей паренхимы, отек перинефральной и периуретеральной клетчатки, экстравазацию мочи в виде перинефральной и периуретеральной тяжистости и скоплений жидкости вокруг почки и мочеточника. Ультразвуковое и рентгенологическое исследования неэффективны в выявлении косвенных признаков уретеролитиаза за исключением пиелокаликоуретероэктазии.
Ключевые слова:
Литература:
The capabilities of computer tomography (CT) in diagnostics of ureterolithiasis were studied. All patients, had an ultrasound (US) of the urinary tracts done before CT, 341 patients had X-ray examinations: survey and excretory urography (EU). Patients (732) with the sharp flank pain – usually with a sign of renal colic — were examined. In 637 patients the clinical picture of renal colic was determined by ureterolithiasis. CT, in all cases, made it possible to establish not only a concretion in the opening of ureter, level of obstruction and size of a stone, but also a whole series of secondary signs indicative of ureter obstruction, that show the degree of its manifestation. Secondary signs were seen with the following frequency: dilatation of the renal collecting system on the side of obstruction – 89.9% of patients; dilatation of ureter – 95.8%; perinephral “ductility” – 57.6%; periureteral “ductility” – 49.6%; perinephral fluid collection – 11.0%; periureteral fluid collection – 6.9%; an increase of kidney dimensions – 25.9%; reduction of density of kidney parenchyma – 45.5%; presence of the soft-tissue rim around the stone in the opening of ureter – 80.2%; thickening of walls of the dilated renal pelvis – 47.4%; thickening of capsule, irregular renal contours – 21.5%. All signs, showed tendency towards growth, the longer the ureter obstruction and its manifestations were present. Diagnostic possibilities of US and Xray methods, in finding of secondary signs of ureter obstruction, were shown to be considerably inferior. Based on the results of this investigation optimum CTmethod of examination of patients with the suspicion of ureter obstruction, and the algorithm of the application of radiological methods of study were developed.
Keywords: