磁共振成像对输尿管梗阻诊断的价值

目的目的探讨磁共振成像(MRU)在输尿管梗阻性疾病诊断中的价值。方法对44例(其中输尿管肿瘤23例,输尿管结石8例,输尿管结核及炎性狭窄5例,输尿管息肉3例,巨输尿管症5例)输尿管梗阻病人进行了MRU检查,并与B超、CT、静脉尿路造影(IVU)、输尿管逆行造影结果进行比较。结果MRU能清楚显示输尿管梗阻的部位,对输尿管梗阻的定位诊断率为100%,定性诊断率为86%。结论MRU对输尿管梗阻的诊断率高,无创且不受肾功能影响,并发症少,是对输尿管梗阻病变的最佳显示方法。     

磁共振尿路成像诊断肾移植输尿管病变的价值

目的 :探讨磁共振尿路成像对肾移植输尿管病变的诊断价值。材料和方法 :16例肾移植后输尿管并发症患者 ,临床诊断移植肾盂积水 13例 ,移植肾周积液 3例 ,用重T2加权快速自旋回波序列和脂肪抑制技术作磁共振尿路成像。结果 :16例均清楚显示移植肾实质及泌尿系集合系统高质量图像 ,输尿管病变得到确诊 ,其中移植肾输尿管狭窄 11例 ,输尿管坏死漏尿致移植肾周积尿 3例 ,输尿管结石 1例 ,输尿管返流 1例。结论 :磁共振尿路成像对肾移植后输尿管病变具有极高诊断价值。     

输尿管梗阻性病变的螺旋CT应用价值

目的 评价螺旋CT在输尿管梗阻性病变的临床应用价值.方法 收集经手术病理及临床证实的76例输尿管梗阻性病变资料.所有病例均行CT平扫或(和)4期增强扫描,并传至后处理工作站行多平面重建(MPR)、曲面重建(CPR)和CT尿路成像(MSCTU),观察螺旋CT各种成像方法诊断病变的能力,并与其他检查技术及手术病理结果进行比较.结果 76例中,输尿管结石38例,输尿管炎性纤维性狭窄21例,肾输尿管结核2例,肾输尿管畸形7例,输尿管癌3例,腹膜后肿瘤压迫输尿管狭窄5例.76例输尿管狭窄多期轴位扫描结合后处理技术均显示了病变的部位、大小、形态、数目、侵犯范围、与邻近结构的关系及尿路梗阻情况.结论 螺旋CT对输尿管梗阻性病变定位、定性诊断具有较好的临床价值.     

单侧输尿管梗阻的CT诊断价值

本文报道经证实的单侧输尿管梗阻３１例，其中肿瘤、息肉１０例，结石１４例，狭窄７例。典型ＣＴ表现：肿瘤息肉为梗阻远端输尿管腔内圆形、椭圆形软组织密度灶，密度均匀或不均匀；结石为梗阻远端输尿管腔内圆形、椭圆形及不规则高密度影，ＣＴ值１８４￣１０８６ＨＵ；单纯性狭窄为梗阻远端输尿管壁的均匀性增厚及逐渐狭窄改变。ＣＴ定位诊断率为９３．５％，定性诊断率为８０．６％。结合分析对比传统Ｘ线检查结果，着重探讨ＣＴ     

256层CTU尿路造影对输尿管梗阻性病变的诊断价值

目的 探讨多层螺旋CT尿路造影(CTU)在诊断输尿管梗阻性病变中的临床价值.方法 收集本院2011年5月～2012年6月的输尿管梗阻性病变30例,均行腹盆腔多层螺旋CT容积扫描,1 mm薄层重建图像传输至Vitrea2工作站,对所获得图像进行容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)等方式后处理.结果 本组术前CTU诊断正确28例,另2例术前怀疑输尿管肿瘤,后经手术病理证实为输尿管结核,CTU的诊断准确率为93%(28/30).CTU成功率100%,图像清晰,诊断准确率高.结论 CTU通过VR、MIP、MPR、CPR后处理,能清晰显示输尿管扩张的整体形态,明确梗阻部位、病变性质、病灶与周围组织的解剖关系,对输尿管梗阻病变的诊断有很高的临床应用价值.     

尿路造影后立即做CT尿路成像诊断输尿管梗阻性病变

目的:在静脉尿路造影(IVU)无法明确输尿管梗阻原因时,评价多层螺旋CT(MSCT)泌尿系成像技术对输尿管梗阻病变的诊断价值。方法:40例经IVU显示为不明原因输尿管梗阻患者即刻接受MSCT平扫,将所得数据资料传至工作站,采用最大强度投影(MIP)、多平面重组(MPR)、曲面重组(CPR)、表面遮盖显示(SSD)或容积重组(VR)等后处理技术,重组泌尿系三维立体图像。结果:40例IVU无法明确输尿管梗阻原因患者中采用MSCT轴面结合三维重组图像能从多个角度清楚地显示尿路全程及其周围组织结构,并显示输尿管梗阻部位的状况,MSCT尿路造影(MSCTU)可很好地弥补IVU检查的不足。结论:与IVU比较,MSCTU图像清晰,对输尿管梗阻性病变有着很高的临床应用价值,可使输尿管病变诊断准确率得到明显提高。     

64层容积CT尿路造影对输尿管梗阻性病变的诊断价值

目的:探讨64层容积CT对输尿管梗阻性病变的临床诊断价值.方法:25例输尿管梗阻性病变患者,均行64层容积CT尿路造影(VCTU)检查.对所获容积数据进行三维重组处理,输尿管重组方法有:最大密度投影、多平面重组、容积再现和曲面重组.结果:25 例病变中,输尿管结石15 例,输尿管癌5例,肾输尿管结核2例,双肾及输尿管畸形1例,先天性巨输尿管畸形1例,输尿管炎性狭窄1例.所有病例均经手术或临床资料证实.VCTU能清楚显示其位置、大小、形态及输尿管梗阻扩张情况.结论:VCTU重组图像清晰,对泌尿系肿瘤、结石或其他尿路梗阻性疾病有着独特的临床应用价值.     

超声对输尿管梗阻性疾病病因的诊断价值

输尿管梗阻性疾病在临床很常见,诊断方法也日益增多,其中超声作为一种无创伤性的简便快捷的诊断手段其价值不容忽视.本文采用CDU对80例输尿管梗阻性疾病进行检查,总结其病因诊断资料,目的在于探讨输尿管梗阻性疾病病因的超声显像检查方法、声像图表现及其诊断价值.     

用自制线圈对大鼠单侧输尿管梗阻行磁共振成像的可行性研究

目的：探讨用自制3in表面线圈在3．0TMR上进行大鼠肾积水成像的可行性。方法：5只Wistar大鼠制备单侧输尿管梗阻模型,于第5天和第10天分别行T1WI、T2WI,扩散加权（DWI）和MR尿路造影（MRU）检查。使用GE3．0TMR扫描仪,3英寸自制表面线圈。两名医师分别独立评价各序列图像质量,一名医师测量两次扫描梗阻侧肾实质厚度和肾盂宽度。结果：两观察者均认为T1WI和T2WI有10／10图像质量为“好”,T1WI中“优”分别为7／10和6／10;T2WI中“优”分别为8／10和7／10;两观察者均认为DWI有8／10达到“好”,3／10达“优”;MRU中“优”分别为6／10和5／10。第5天到第10天梗阻侧肾积水程度显著加重（P〈0．05）。结论：自制的三英寸线圈在3．0TMR上进行肾积水大鼠模型常规T1WI、T2WI和DWI成像能够获得较满意的图像,满足大鼠肾积水实验对积水程度观测的需求。     

螺旋CT泌尿系成像对输尿管病变诊断价值的初步研究

目的：探讨螺旋ＣＴ泌尿系成像（ＳＣＴＵ）对输尿管病变的诊断价值。方法：２７例输尿管病变者,行螺旋ＣＴ容积扫描,图像经后处理获得泌尿系立体图像。结果：①ＳＣＴＵ图像好坏与扫描方法、图像重建方法等密切相关。②ＳＣＴＵ图像可见,结石位置、大小及扩张的肾盂和输尿管;肿瘤者局部管腔内造影剂柱变细或突然中断,管壁不光整;单纯狭窄者管腔呈逐渐变细,管壁无增厚。迷走血管压迫狭窄者均位于肾盂输尿管交界处;重复肾并输尿管畸形者显示双肾盂、双输尿管;输尿管瘘者显示瘘口位置、走行。结论：ＳＣＴＵ可多方位观察输尿管病变,可从二维及三维立体图像上获得更多诊断信息。与静脉泌尿系造影（ＩＶＵ）相比,有明显优越性。     

低场磁共振水成像对输尿管病变诊断初探

目的 :评价低场磁共振泌尿系水成像 (MRU)在输尿管疾病、特别是梗阻性疾病中的诊断价值。方法 :对38例 (其中肿瘤 15例、结石 10例、输尿管炎症或结核 7例、狭窄 3例、先天畸形 3例 )患者先行MRU检查后 ,部分辅以MR平扫 ,并与B超、CT扫描及IVP检查结果进行比较。结果 :MRU对输尿管先天性非梗阻性病变诊断准确率达6 7% ,低于IVP ,对输尿管梗阻性疾病的定位诊断准确率达 10 0 % ,定性诊断准确率达 89% ,优于CT及B超。结论 :低场磁共振泌尿系水成像 (MRU)对输尿管病变的定位、定性诊断准确率高 ,值得推广应用 ,特别是对疑有输尿管梗阻性病变患者、碘过敏患者、年老体弱及儿童患者 ,更应该作为首选检查方法。     

Imaging in ureteral complications of renal transplantation: value of static fluid MR urography

Ureteral obstruction is an infrequent complication after renal transplantation that may cause rapid loss of transplant function. We tested static fluid MR urography for determining the cause of graft hydronephrosis. Magnetic resonance urography was performed in nine transplants with dilated collecting systems on ultrasound. A heavily T2-weighted 3D turbo spin-echo sequence on a 1.5-T scanner was used and maximum intensity projections were obtained. The patients also underwent excretory urography (n = 1), renal scintigraphy (n = 1), antegrade pyelography (n = 3), voiding cystourethrography (n = 4), and non-enhanced CT (n = 2). Six patients had pathologic conditions including ureteral stricture, compression by lymphoceles, implantation stenosis, vesicoureteral reflux, and late-occurring transitional cell carcinoma at the implantation site. Static MRU was able to diagnose or exclude a dilation of the graft collecting system. It visualized the course of the ureters and localized the obstruction site in four of five obstructed transplants. In one case the ureter was obscured by lymphoceles, which were demonstrated by hydrographic MRU as well. The definite cause for obstruction was provided in only 2 of 5 cases. Dilation due to vesicoureteral reflux could not be differentiated. The current multimodality approach to renal transplant imaging already provides comprehensive assessment of graft hydronephrosis. Static MRU may be useful in some cases since complications associated with intravenous iodinated contrast or antegrade pyelography can be avoided. Its main drawback, the lack of functional information, may be overcome by combining it with contrast-enhanced MRU. Received: 18 February 1999; Revised: 23 July 1999; Accepted: 18 November 1999     

磁共振尿路造影诊断输尿管肿瘤的价值

目的: 评价磁共振尿路造影(MRU)诊断输尿管肿瘤的价值.材料和方法: 回顾性分析24例经病理证实的输尿管肿瘤的MRU表现.MRU采用重T2W 3D TSE序列并于梗阻端行常规MRI.结果: 24例MRU均表现为输尿管突然截断,与术中所见梗阻部位及程度相符.MRU对多发病变(肾盂、输尿管、膀胱移行细胞癌)的显示,也与手术所见相符.MRI在22例输尿管梗阻端发现软组织肿块,2例管壁增厚.结论: MRU能准确显示输尿管梗阻程度、部位,MRI能准确显示梗阻处输尿管的形态改变、软组织肿块,有助于定性诊断.     

静脉尿路造影术与MR水成像技术在泌尿系统疾病检查中的对比分析

目的:评价静脉尿路造影技术(IVU)与低场强磁共振泌尿系水成像技术(MRU)在泌尿系统疾病检查 中的应用价值。方法:对20例(正常5例,输尿管结石8例,输尿管移行细胞癌1例,输尿管中下段狭窄、扭曲2例, 肾囊肿2例,肾透明细胞癌2例)泌尿系统疾病患者,均行IVU与MRU检查,并进行对比分析。结果:IVU和 MRU检查均能清晰显示输尿管的梗阻部位,定位正确率100%,而定性正确率MRU高于IVU,且对输尿管梗阻的 病变显示较佳,但MRU不能直接观察肾脏的分泌功能。结论:泌尿系统疾病患者应首选IVU检查,以观察其功能 和形态,而对输尿管有梗阻或肾脏有占位性病变的患者应选用MRU,对儿童及不能耐受IVU检查的患者MRU也 可作为首选。     

Utility of gadolinium-enhanced MR urography in detection of bladder carcinoma

Objectives

To evaluate the diagnostic accuracy of MR urography (MRU) in detecting bladder carcinoma.

Methods

A retrospective review of 107 MRU exams obtained to evaluate for possible upper urinary tract urothelial carcinoma from 5/2005 to 5/2009 was performed by two experienced abdominal radiologists. Interpretation of the presence or absence of bladder carcinoma and lesion conspicuity in each imaging phase was made using 5-point confidence grading scales. Exams included 3D T1-weighted spoiled gradient-recalled echo images through the kidneys, ureters and bladder in the coronal plane during parenchymal phases and in both coronal and axial planes during pyelographic phases after intravenous administration of gadolinium and furosemide. Standard of reference was cystoscopy or cystectomy within 30 days of MRU. Statistical measures of performance, including receiver operating characteristics area under the curve (Az) values were calculated.

Results

Bladder carcinoma was present in 26/107 patients (24%). Sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Az value were 73.1%, 91.4%, 86.9%, 73.1%, 91.4%, 0.89 for the first reviewer, and 84.6%, 75.3%, 77.6%, 52.4%, 93.8%, 0.86 for the second. Lesion conspicuity was superior on the parenchymal phase compared to the pyelographic phase (p = 0.04).

Conclusions

MRU obtained for suspicion of upper urinary tract TCC has a moderate accuracy in detecting bladder carcinoma.     

MSCTA和MSCTU对肾盂输尿管连接部梗阻的诊断价值

目的：探讨MSCT血管成像（MSCTA）及尿路成像（MSCTU）在肾盂输尿管连接部梗阻（UPJO）诊断中的价值。方法：回顾性分析经手术病理证实的16例UPJO患者的MSCTA及MSCTU影像资料,利用多种后处理重组技术（MPR、CPR、MIP、VR）进行重组。结果：16例肾盂输尿管连接部梗阻中,梗阻位置全部诊断正确。梗阻原因诊断为输尿管息肉1例,血管压迫3例,炎性狭窄12例。术前诊断与手术探查及病理结果基本一致。结论：MSCTU和MSCTA可作为UPJO术前评估的常规方法,在诊断引起UPJO的疾病方面具有重要价值。     

磁共振尿路水成像技术(MRU)的临床应用探讨

目的 探讨磁共振尿路水成像的检查技术及临床应用价值。方法 采用快速自旋回波（FSE）、重T2WI技术对35例患行磁共振尿路水成像检查，所有图像后处理均采用最大信号强度投影（MIP）技术。结果 检查35例，27例MRU显示有尿路梗阻，与常规MRI结合在揭示病变和尿路梗阻之间的关系方面有独到之处。结论 MRU能显示尿路梗阻部位、程度，与MRI结合能更清晰地诊断尿路梗阻的病因。MRU将成为诊断泌尿系疾病的一种新型无创伤影像手段。     

Diagnostic value of diuretic-enhanced excretory MR urography in patients with obstructive uropathy

PURPOSE: Ultrasonography and conventional intravenous urography are most common methods in diagnosis of obstructive uropathies. The disadvantage of ultrasonography is inability of visualizing middle and lower one thirds of ureter, while intravenous urography is using radiation, also functionally extra loading effect on kidneys. In this study, the diagnostic value of MR urography on obstructive uropathy were investigated. MATERIALS AND METHODS: Forty five patients who were suffered from obstructive uropathy examined by ultrasonography, intravenous urography and diuretic-enhanced excretory MR urography by using MR-contrast-agent. RESULTS: MR urography established accuracy rate of 92.8% for stone diseases which formed the largest group in this study, however, in other causes of obstructive uropathy, MR urography provide 100% correct diagnosis. CONCLUSION: MR urography provide high quality images for diagnosing and determining causes of urinary obstruction defining position and severity of dilatations as well as showing localization of the pathology. We think that MR urography should be a primary investigation in patients with obstructive uropathy who have contrast agent and X-ray contrindication.     

高场强MR泌尿系水成像在输尿管梗阻性疾病中的应用

目的 :提高高场强泌尿系水成像 (MRU)对输尿管梗阻性疾病诊断正确性。方法 :对 33例输尿管梗阻性疾病患者行MRU检查 ,作出影像学诊断 ,进行手术病理追踪证实。结果 :MRU对输尿管的梗阻部位的定位诊断准确率 10 0 % ,定性诊断准确率 82 %。结论 :MR图像是诊断输尿管梗阻性疾病的主要依据 ,临床表现是诊断的重要辅助依据 ;MRU对输尿管梗阻性病变的定位准确率高 ,定性诊断准确率亦较高 ,但要结合临床表现及进一步积累经验。