Definição do nível da junção ureterovesical pela tomografia computadorizada

• Autor(a) principal: Freire Filho, Edison de Oliveira [UNIFESP]
• Data de Publicação: 2006
• Outros Autores: Leão, Alberto Ribeiro de Souza [UNIFESP], Capobianco, Júlia [UNIFESP], Szejnfeld, Jacob [UNIFESP], D'Ippolito, Giuseppe [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0100-39842006000600009; http://repositorio.unifesp.br/handle/11600/3375
• topic: Calculus; Ureter; Ureteral obstruction; Lithiasis; X-ray computed tomography; Cálculo; Ureter; Obstrução ureteral; Litíase; Tomografia computadorizada por raios X

OBJECTIVE: To define, by means of computed tomography, the level of ureteral implantation into de bladder. MATERIALS AND METHODS: We have measured the distances from the ureteral meatus to the acetabulum, and to the superior margin of the pubic symphysis, as well as the bladder volume, using contrast enhanced computed tomography of the pelvis in 46 patients (31 male and 15 female) in the age range between 18 and 45 years, with at least one of the ureteres filled with excreted contrast material. The Student t test has been applied to determine eventual statistically significant differences between groups. RESULTS: The level of ureteral implantation into the bladder was, on average, 10.6 ± 8.1 mm below the acetabular roof, and 29.7 ± 9.5 mm above the superior margin of the pubic symphysis. In patients with bladder repletion volume of < 200 ml and > 200 ml, the level of ureteral implantation into the bladder was, respectively, on average, 11.6 ± 7.3 mm and 10.2 ± 8.4 mm below the acetabular roof (p = 0.61), and 28.3 ± 7.3 mm and 30.3 ± 10.2 mm above the superior margin of the pubic symphysis (p = 0.52), and in male and female men patients, respectively, on average, 11.8 ± 8.0 mm and 8.3 ± 8.0 mm below the acetabular roof (p = 0.17), and 27.7 ± 9.2 mm and 33.9 ± 8.8 mm above the superior margin of the pubic symphysis (p = 0.34). CONCLUSION: Calcifications located < 3 cm below the acetabular roof and < 1.5 cm above the superior margin of the pubic symphysis probably do not represent ureteral calculi. Vesical repletion or sex have no significant influence on the ureteral meatus position.