Urachus的成像。

IF 5.2 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Radiographics Pub Date : 2025-05-01 DOI:10.1148/rg.240122
Maria Zulfiqar, Parker J Brown, Komal Chughtai, Pooja Navale, Nelly Tan, Motoyo Yano, Asmaa Aamir, Dane Van Tassel, Cary Lynn Siegel, Akira Kawashima
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引用次数: 0

摘要

尿管是尿囊和泄殖腔腹侧的残余纤维索,在脐水平连接膀胱和前腹壁。作者探讨了尿管的胚胎起源,描述了其正常解剖结构,随后讨论了不同成像方式(包括US、CT和mri)所见的尿管病理状况。虽然是一种退化结构,但尿管内可能存在重大疾病,包括继发于不同程度的尿管内不完全内陷的先天性异常,范围从局灶性通畅(尿管内囊肿、憩室和窦)到完全通畅(尿管内未闭)。先天性异常的频谱可以表现为各种临床表现,并且通常在感染时在影像学上发现。因此,了解尿管的胚胎发生对于理解尿管异常的影像学表现至关重要。非肿瘤性尿管肿块可呈炎性,有时难以与恶性肿瘤区分。子宫内膜异位症可累及女性的输卵管。肿瘤性尿管实体包括粘液囊腺瘤,它可以破裂并伴有粘液性腹水。腺癌是泌尿道最常见的恶性肿瘤,常可累及膀胱。其他恶性尿管实体包括尿路上皮癌和转移。尿管病理状况的模拟可引起诊断上的误解,包括原发性膀胱恶性肿瘤、感染、胆结石脱落或阑尾结石。本综合综述旨在提高放射科医生在识别和解释尿路异常方面的熟练程度,从而有助于改善患者的预后。©RSNA, 2025本文可获得补充材料。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Imaging of the Urachus.

The urachus is a remnant fibrous cord of the allantois and the ventral aspect of the cloaca that connects the urinary bladder to the anterior abdominal wall at the level of the umbilicus. The authors explore the embryologic origins of the urachus and delineate its normal anatomy, followed by a discussion of urachal pathologic conditions seen with different imaging modalities-including US, CT, and MRI-using a case-based approach. Although it is a vestigial structure, the urachus can harbor significant disease, including congenital anomalies arising secondary to varying degrees of incomplete involution of the urachus and ranging from focal patency (urachal cyst, diverticulum, and sinus) to complete patency (patent urachus). The spectrum of congenital abnormalities can manifest with various clinical findings and is often discovered at imaging when infected. Understanding the embryogenesis of the urachus is therefore crucial for understanding the imaging manifestations of urachal abnormalities. Nonneoplastic urachal masses can be inflammatory and sometimes difficult to differentiate from malignancy. In women, the urachus can be involved by endometriosis. Neoplastic urachal entities can include mucinous cystadenoma, which can rupture with associated mucinous ascites. Adenocarcinoma is the most common urachal malignancy and frequently can extend to involve the urinary bladder. Other malignant urachal entities include urothelial carcinoma and metastasis. Mimics of urachal pathologic conditions can cause diagnostic misperception and include primary bladder malignancy, infections, and dropped gallstones or appendicoliths. This comprehensive overview aims to enhance radiologists' proficiency in recognizing and interpreting urachal abnormalities, thus contributing to improved patient outcomes. ©RSNA, 2025 Supplemental material is available for this article.

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来源期刊
Radiographics
Radiographics 医学-核医学
CiteScore
8.20
自引率
5.50%
发文量
224
审稿时长
4-8 weeks
期刊介绍: Launched by the Radiological Society of North America (RSNA) in 1981, RadioGraphics is one of the premier education journals in diagnostic radiology. Each bimonthly issue features 15–20 practice-focused articles spanning the full spectrum of radiologic subspecialties and addressing topics such as diagnostic imaging techniques, imaging features of a disease or group of diseases, radiologic-pathologic correlation, practice policy and quality initiatives, imaging physics, informatics, and lifelong learning. A special issue, a monograph focused on a single subspecialty or on a crossover topic of interest to multiple subspecialties, is published each October. Each issue offers more than a dozen opportunities to earn continuing medical education credits that qualify for AMA PRA Category 1 CreditTM and all online activities can be applied toward the ABR MOC Self-Assessment Requirement.
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