Features of examination of patients with kidney and ureter injuries

E. Egorova, Zavazhat M. Magomedova
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Abstract

The aim of the study was to assess the capabilities of magnetic resonance imaging (MRI) in the diagnosis of complications in patients with combined kidney and ureteral injuries during different periods of traumatic disease. The observation group included 139 patients aged from 18 to 72 years with renal and ureteral injuries, who were injured in traffic accidents. Complications of renal trauma occurred in 74 of 128 patients with isolated and combined injuries (59.2%), strictures were observed in 9 of 11 patients with ureteral trauma in the late period, and 1 of them had a failure of vesicoureteral anastomosis. The most common complication in the early and late periods of traumatic disease, occurring in 25.0% of cases, was pyelonephritis; patients with abscesses (12.5%) and acute renal failure (11.7%) were also common. The methods of choice for the diagnosis of combined injuries in the acute period were: ultrasound examinations according to the eFAST protocol and multislice computed tomography according to the “Polytrauma” protocol. Multiparametric magnetic resonance imaging (mpMRI) of the kidneys and ureters was indicated in the periods of early and late manifestations of traumatic disease to detect renal complications when there is a discrepancy between clinical data, ultrasound and multislice computed tomography (MSCT) findings, and there are contraindications for MSCT with intravenous contrast.
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肾及输尿管损伤患者的检查特点
本研究的目的是评估核磁共振成像(MRI)在创伤性疾病不同时期诊断肾输尿管合并损伤患者并发症的能力。观察组患者139例,年龄18 ~ 72岁,因交通事故致肾、输尿管损伤。128例单纯性和复合性损伤患者中有74例(59.2%)出现肾外伤并发症,11例输尿管外伤患者中有9例出现晚期狭窄,其中1例膀胱输尿管吻合术失败。创伤性疾病早期和晚期最常见的并发症是肾盂肾炎,发生率为25.0%;脓肿(12.5%)和急性肾功能衰竭(11.7%)也很常见。急性期合并损伤的诊断方法选择:根据eFAST方案的超声检查和根据“多发伤”方案的多层计算机断层扫描。当临床资料与超声、多层螺旋ct (MSCT)表现不一致,且MSCT联合静脉造影剂存在禁忌症时,应在创伤性疾病的早期和晚期对肾脏和输尿管进行多参数磁共振成像(mpMRI)检查,以发现肾脏并发症。
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