超音波常規檢視中段輸尿管：快速診斷中段輸尿管結石及大幅減少輻射暴露

Routine Ultrasonic Assessment of the Middle Third of the Ureter: Prompt Diagnosis of Significant Calculi with Minimal Radiation Exposure

目的：驗證超音波檢查中段輸尿管結石的診斷價值。超音波檢查中段輸尿管結石被認為是困難和費時的。然而，我們發現如果我們作常規超音波檢視中段輸尿管，這將有不同的結果。方法：本研究是蒐集中段輸尿管結石接受體外震波碎石的患者，進行回顧性研究。收集臨床資料和影像學報告進行分析，最初的超音波檢查含常規檢視中段輸尿管。在36個月中（從2006年7月至2009年6月）有63例。記錄檢測中段輸尿管結石所花費的額外時間。進行統計分析，找出哪些因素會影響結石檢測花費的額外時間。結果：常規超音波檢視中段輸尿管，可檢出90％（57/63）的中段輸尿管結石。平均檢測結石花費的額外時間為71.98秒，大多數在兩分鐘內（85.7％）。花費的額外時間在中高度輸尿管積水患者明顯較短。結論：常規超音波檢視中段輸尿管，可以快速診斷中段輸尿管結石。大多數患者可避免靜脈腎臟攝影和電腦斷層掃瞄。這些患者受到的輻射照射，可以減少到最低限度。

Purposes: To verify the value of ultrasound in the diagnosis of significant calculi in the middle third of the ureter in terms of difficulty and time consumption. Methods: This study was a retrospective chart review of patients who had received extracorporeal shock wave lithotripsy for calculi in the middle third of the ureter over a period of 36 months from July 2006 to June 2009. Clinical data and reports of imaging studies were collected for analysis. Primary ultrasound with routine assessment of the middle third of the ureter was performed in 63 cases. Extra time spent in detection of calculi was calculated from the records of the sonograms. Statistical analysis was performed to determine the factors which may have influenced the time spent in detection of calculi. Results: Routine ultrasonic assessment of the middle third of the ureter detected 90% (57/63) of significant calculi. The extra time spent in detection of calculi was 71.98 seconds on average. Most of the significant calculi were detected in two minutes (85.7%). Extra time spent in detection of calculi was significantly less in patients with high grade hydroureter. Conclusions: With routine ultrasonic assessment of the middle third of the ureter, most patients with significant calculi can be diagnosed promptly. Excretory urography and CT can be avoided in most patients and radiation exposure can be reduced to a minimum.