多层螺旋CT泌尿系造影在复杂性上尿路梗阻性疾病中的诊断价值

目的 探讨多层螺旋CT泌尿系造影(MSCTU)在复杂性上尿路梗阻性疾病中的诊断价值.方法 206例泌尿系B超诊断上尿路积水但其他传统影像学检查未能明确梗阻位置及病因的患者,利用MSCT进行全尿路平扫和增强延迟扫描,扫描方法 通过螺旋CT工作站(Alatoview)进行图像后处理,包括多平面重建(MPR)、最大强度投影(MIP)、表面遮盖显示(SSD)、CT仿真内窥镜(CTVE)等方法 ,结合临床资料、手术中所见及术后病理检查方法 进行回顾性分析.方法 206例均获得立体、直观的泌尿系全程图像,清晰地显示出上尿路梗阻部位、积水程度、病变性质及病变部位与周围结构的关系.其中193例行手术治疗,术中所见与MSCTU显示的影像相符,诊断正确率98.4%.结论 MSCTU是目前诊断复杂性上尿路梗阻性疾病最佳的检查方法 .

Value of multi-slice CT urography (MSCTU) in diagnosing complicated urinary tract obstructive diseases

Objectives To study the value of multi-slice CT urography (MSCTU) in diagnostic urinary tract obstructive diseases.Methods 206 patients were found with upper urinary tract obstructive diseases by ultrasound B but the obstructive locations and causes of the diseases failed to be identified by other conventional imaging techniques. These patients underwent multi-slice spiral CT urography (MSCTU), either through plain scan or through enhanced scan. The data of CT scan were transmitted to the workstation, where the images of the urinary system were reconstructed by means of multi-plannar reconstructtion (MPR), maximam-intensity-projection (MIP), surface-shade-display (ssd), and CT virtual endoscopy(CTVE). The clinical data, operating data and pathological data were retrospectively analyzed.Results All of these 206 cases had three-dimensional intuitional urinary tract imaging, which displayed clearly an upper urinary tract obstructive location, hydrops level, affection property and the relation of the obstructions with the structures surrounding them. Of the 206 cases, 193 received surgical operations. During the operation, what was found was in concord with the helical CT results. The coincidence rate of CT scan and clinical diagnosis was 98.4%.Conclusions MSCTU proves very valuable in detecting complicated upper urinary tract diseases.