多排螺旋CT纵剖面重建对输尿管梗阻性疾病的诊断价值

目的探讨多排螺旋CT纵剖面重建对输尿管梗阻性疾病的诊断价值。方法应用Lightspeed16螺旋CT机,对34例输尿管梗阻性病变的病人进行轴位面扫描,并对所得数据进行纵剖面重建。所有病例除2例腹膜后淋巴管转移致输尿管受压外,均经手术病理证实。结果34例患者中,输尿管结石22例,输尿管炎症2例,输尿管癌3例,肾盂输尿管连接处狭窄3例,输尿管囊肿1例,下腔静脉后输尿管1例,腹膜后淋巴结转移压迫输尿管者2例。CT纵剖面重建可显示输尿管腔内结石22处,输尿管管壁增厚者5例。增强扫描的5例病人中,CT值增加约20～35HU,延迟扫描18例表现为轻度积水,6例表现为中度积水,2例表现为重度积水,1例无积水。结论纵剖面重建图像对输尿管梗阻性病变的诊断具有较高的临床应用价值。

Diagnostic Value of MSCT Longitudinal-reconstruction in the Ureteral Obstruction

Objective To evaluate the diagnostic value of MSCT longitudinal reconstruction in the ureteral obstruction.Methods 34 patients with ureteral obstruction were scaned transversely and longitudinally by GE Lightspeed 16 CT scanner and the images were reconstructed with three-dimensional software.All cases were proved by operation and pathology except for 2 cases of uretal obstruction compressed by retroperitoneal lymph nodes.Results In 34 cases,there were 22 cases of ureteral calculi,2 cases of ureteritis,3 cases of carcinoma of ureter,3 cases of pelvisureteral conjunction stricture,1 case of ureteral cyst,1 case of retrocaval ureter and 2 cases of ureter compressed by retroperitoneal metastatic lymph nodes.On longitudinal reconstruction images,22 lesions of calculi in the ureter and thickened uretal wall were showed.Contrast-enhanced CT scan was preformed in 5 cases,the CT values of lesions were increased about 20~35 HU,after administration of contrast medium,and light hydronephrosis in 18 cases,medium hydronephrosis in 6,serious hydronephrosis in 2 and no hydronephrosis in one case were showed on delayed contrast-enhanced scan.Conclusion Longitudinal reconstruction image is of significant value in diagnosis of ureteral obstruction.