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首页> 外文期刊>Urology >Prospective study on ultrasonography plus plain radiography in predicting residual obstruction after extracorporeal shock wave lithotripsy for ureteral stones.
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Prospective study on ultrasonography plus plain radiography in predicting residual obstruction after extracorporeal shock wave lithotripsy for ureteral stones.

机译：超声加平片对预测输尿管结石体外冲击波碎石术后残余阻塞的前瞻性研究。

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OBJECTIVES: To compare ultrasonography (US) and plain radiography with intravenous urography (IVU) in predicting ureteral obstruction after in situ extracorporeal shock wave lithotripsy (ESWL) for ureteral stones. METHODS: From April 1998 to September 2000, 100 consecutive patients with solitary ureteral stones were treated by primary in situ ESWL. ESWL failures were salvaged by ureteroscopic lithotripsy. Ninety-three patients completed the follow-up assessment. US and IVU were performed when plain radiography showed no residual stone. The occurrence of hydronephrosis on US was compared with IVU, the reference standard for ureteral obstruction. RESULTS: Of the 93 patients, 72 were men and 21 women (mean age 52 years; mean stone size 11.2 mm). ESWL successfully treated 70 ureteral stones (75%), and the 23 failures were treated by ureteroscopic lithotripsy. Sixty-nine patients without hydronephrosis on US had no ureteral obstruction on IVU. Of the 24 patients who had hydronephrosis on US, 8 had ureteral obstruction on IVU. Of the 85 patients who had no ureteral obstruction on IVU, 69 patients showed no evidence of hydronephrosis on US. However, all patients with ureteral obstruction on IVU demonstrated hydronephrosis on US. The sensitivity, specificity, and positive and negative predictive value concerning sonographic hydronephrosis in the prediction of ureteral obstruction was 100%, 81%, 33%, and 100%, respectively. US alone could not define the cause of ureteral obstruction. CONCLUSIONS: Plain abdominal radiography plus US is highly sensitive for screening ureteral obstruction after primary in situ ESWL for ureteral calculi. It can save up to 74% of patients from the potential risk of IVU. The detection of the cause of obstruction by IVU is only necessary when sonographic evidence of hydronephrosis is present.
机译：目的：比较超声检查（US）和普通放射线照相术与静脉输尿管造影（IVU）在预测输尿管结石体外原位体外冲击波碎石术（ESWL）后的输尿管阻塞的情况。方法：自1998年4月至2000年9月，连续100例孤立性输尿管结石患者接受原位原位ESWL治疗。通过输尿管镜碎石术挽救了ESWL失败。 93名患者完成了随访评估。当普通放射线照相没有结石残留时，进行US和IVU检查。将美国肾盂积水的发生率与输尿管梗阻参考标准IVU进行了比较。结果：93例患者中，男性72例，女性21例（平均年龄52岁;平均结石直径11.2毫米）。 ESWL成功治疗了70例输尿管结石（75％），并通过输尿管镜碎石术治疗了23例失败者。 69例在美国没有肾积水的患者在IVU上没有输尿管阻塞。在US肾积水的24例患者中，IVU输尿管梗阻8例。在85例IVU中无输尿管阻塞的患者中，有69例在US上无肾积水的迹象。但是，所有IVU输尿管梗阻患者均在US表现为肾积水。超声肾盂积水在输尿管梗阻预测中的敏感性，特异性以及阳性和阴性预测值分别为100％，81％，33％和100％。仅美国就无法确定输尿管梗阻的原因。结论：原发性原位ESWL检查输尿管结石后，腹部X线平片加US对筛查输尿管梗阻非常敏感。它可以使多达74％的患者免于IVU的潜在风险。仅当存在肾盂积水的超声检查证据时，才有必要通过IVU检测阻塞原因。

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