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目的：探讨ＭＲＵ在小儿泌尿道畸形疑难病例诊断中的应用。材料和方法：用重Ｔ２加权ＦＳＥ序列，脂肪抑制技术对１７例４天～１４岁、ＩＶＵ未显影或（和）ＩＶＵ，ＵＳ诊断不明的病例作ＭＲＵ检查。结果：（１）能作定性诊断的疑难病例９例，包括：多囊性发育不良肾、少见类型的异位输尿管囊肿以及重度积水的巨输尿管各２例；马蹄肾并发输尿管结石与积水、特大型先天性膀胱Ｈｕｔｃｈ 憩室以及脐尿管囊肿各１例。（２）能准确定位并有肾脏多囊性疾病等鉴别清楚、满足手术需要者５例，皆为盂管交界部梗阻。（３）显示两侧重度尿路积水、提示需作其他相应检查以确定病因者３例，包括：后尿道瓣膜２例，神经原性膀胱１例。结论：ＭＲＵ是无创性确诊小儿泌尿道畸形疑难病例的理想手段，必须强调在全面对比分析ＭＩＰ图像、原始图像、Ｔ２加权轴位像以及在监视器荧屏上三维旋转时的所见后进行综合诊断。
Objective: To investigate the application of MRU in the diagnosis of difficult cases of pediatric urinary tract malformations. MATERIALS AND METHODS: MRU examinations were performed on 17 cases of 4-year-old to 14-year-old, with undeveloped IVU or (and) IVU, US diagnosed with T2 weighted FSE sequence and fat suppression technique. Results: (1) 9 cases were diagnosed as difficult cases, including 2 cases of polycystic kidney dysplasia, rare type of ectopic ureter cyst and 2 cases of severe ureteral giant ureter. Horseshoe kidney complicated with ureteral calculi and hydrocephalus , Large congenital bladder Hutch diverticulum and urachal cyst in 1 case. (2) can accurately locate and have polycystic kidney disease identified clearly, to meet the needs of surgery in 5 cases, all for the obstruction of the junction of the canal. (3) showed severe urinary tract hydronephrosis on both sides, suggesting the need for other appropriate examination to determine the cause in 3 cases, including: 2 cases of posterior urethral valve, neurogenic bladder in 1 case. CONCLUSIONS: MRU is an ideal method for the noninvasive diagnosis of difficult cases of pediatric urinary tract deformities. It must be emphasized that comprehensive diagnosis of MIP images, original images, T2-weighted axial images, and post-3D observations of the monitor screen should be emphasized .