MRU对上尿路积水及其病因诊断价值的探讨

目的 通过磁共振尿路造影(MRU)与静脉尿路造影(IUP)、B超、电子计算机断层扫描(CT)及手术、病理学检查和临床结果对照研究,评价MRU在上尿路积水及其梗阻原因诊断中的价值。 方法 21例患者伴不同程度肾盂输尿管积水共30条,采用GE0.5T磁共振机检查,应用FSE序列重T2WI获得MRU冠状位原始单层图像,所有图像均作最大信号投影(MIP)重建。结果 MRU对上尿路积水诊断符合率达96.7％,与B超及CT类似,优于IUP;梗阻原因诊断符合率达86.7％,优于IUP与CT,但明显优于B超(P<0.01)。 结论 无创、无需对比剂及不依赖肾功能的MRU在上尿路积水和梗阻原因影像学诊断中发挥着重要作用,尤其是在B超不能显示病因、CT可疑阴性结石、IUP显影差或不显影时是最好的替代方法。

Study on evaluation of MR urography in diagnosis of the upper urinary tract ureterohydronephrosis and cause

Objective To evaluate the coincident ratio of MR urography(MRU) in demonstrating the ureterohydronephrosis and cause of the upper urinary tract obstruction by comparing with IUP,B-ultrasound,CT,surgical operation,pathology and clinical result. Methods 30 tracts with ureterohydronephrosis in 21 cases were examined with the coronary heavily T2WI FSE sequence by GE 0.5 T machine to yield the source images of MRU.All the images were reconstructed with maximum intensity projection(MIP). Results The coincident ratio of diagnosing the ureterohydronephrosis was 96.7% in MRU. It was the same as B-ultrasound and CT,but superior to lUP.The coincident ratio of detecting the cause of obstruction was 86.7%, which was mildly superior to IUP and CT and showed statistically highly singnificant(P<0.01) comparing with ultrasound. Conclusions MRU does not require ionizing radiation or contrast medium,does not depend on renal function.That is noninva-sive plays an important role in medical imaging diagnosis of ureterohydronephrosis and cause of the upper urinary tract obstraction. MRU is the best alternative especially unfavourable to ultrasound, CT or IUP.