MSCTU诊断泌尿系统先天性疾病的价值:与IVU、MRU对比研究

目的探讨多层螺旋CT尿路成像（MSCTU）在诊断泌尿系统先天异常方面的特点、成像方法及其临床应用价值，并将其与IVU、MRU进行比较。方法搜集4年间临床资料完整的泌尿系先天异常患者83例，对其影像资料进行对比分析。结果83例患者中，52例行IVU检查，40例行MSCTU检查，47例行MRU检查。IVU、MSCTU、MRU对泌尿系先天异常总的定性诊断的正确率分别为48．21％，95．83％，72％，总的定位诊断的正确率分别为57．14％，100％，90％。对伴轻度上尿路梗阻病变的定性诊断正确率分别为46．67％，100％，33．33％，定位诊断正确率分别为53．33％，100％，66．67％。对伴中度上尿路梗阻病变的定性诊断正确率分别为75％，100％，75％，定位诊断正确率分别为87．50％，100％，93．75％。对件重度上尿路梗阻病变的定性诊断正确率分别为32％，85．71％，90．90％，定位诊断正确率分别为40％，100％，100％。结论MSCTU对显示泌尿系先天异常的整体解剖形态和细微病理变化能力强，能明显提高诊断率，可作为首选检查方法。MRU是一种安全可靠的、无创伤性的检查方法，不用对比剂，可显示尿路扩张情况、梗阻部位、梗阻端形态，尤其对碘过敏或IVU不显影、中重度肾积水的病人更为适用。

Diagnostic evaluation of MSCTU in the con genital malformation of urinary systen disease:comparison with IVU and MRU

Objective To evaluate the imaging methods,characteristics,diagnostic value of multi-slice CT urography(MSCTU) in congenital abnormities of urinary system, and to compare it with intravenous urography (IVU) and MR urography (MRU). Methods To collect 83 urinary congenital abnormities cases in four years, the data were analyzed. Several techniques, including multiplanar reformation (MPR), curved planar reformation (CPR), volume rendering (VR), maximum intensity projection (MIP) and virtual endoscopy(VE) were post-processed by using commercial software (ADW 4.2). Results A total of 83 patients with urinary congenital abnormities received IVU(n=52), MSCTU(n=40) and MRU(n=47). By IVU, MSCTU, MRU, the total correct rates of definitive diagnosis were 48.21%, 95.83%, 72%, the total correct rates of locating diag-nosis were 57.14%, 100%, 90%. With low-grade upper urinary tract obstruction, the correct rates of definitive diagnosis were 46.67%, 100%, 33.33%, the correct rates of locating diagnosis were 53.33%, 100%, 66.67%. With middle-grade upper urinary tract obstruction, the correct rates of definitive diagnosis were 75%, 100%, 75%, the correct rates of locating diagnosis were 87.5%, 100%, 93.75%. With marked-grade upper uri-nary tract obstruction,the correct rates of definitive diagnosis were 32%, 85.71%, 90. 90%, the correct rates of locating diagnosis were 40%, 100%, 100%. Conclusion MSCTU has clear, dimensional feature and has strong ability of displaying total anatomy shape and tiny pathology change of congenital abnormities in the urinary system.It is a very useful method for detecting the congenital abnormities in the urinary system. Basically, IVU can be replaced by MSCTU. MRU is a safe,reliable and non-invasive examination method. The method can manifest urinary tract dilatation, obstruction loca-tion and obstruction shape. It is more fitful to patients who are hypersusceptibility to iodine,poor develop during IVU or middle/heavy hydronephrosis.