CR在静脉肾盂造影中的应用价值

目的：探讨计算机X线成像（computed radiography，CR）在静脉肾盂造影中的应用。方法：随机抽取2002年11月-2005年11月200例使用AGFA ADC SOLO系统行静脉肾盂造影者影像资料，分析图像的显示情况。结果：200例患者中，共85例原始图像显示欠佳。其中78例因曝光条件不恰当引起图像显示不理想。经CR处理后得到明显改善，另7例因病理改变所致。经CR处理后无明显改善。结论：CR系统能较好的显示泌尿系统病变，对诊断很有价值。     

16层螺旋CT泌尿系成像技术的优势

泌尿器官解剖结构复杂,单纯的CR静脉肾盂造影虽然比常规X线静脉肾盂造影在图像质量上有很大的提高[1],但毕竟是二维重叠图像,在泌尿器官的病变定位诊断上仍有一定的困难。16层螺旋CT扫描速度快、范围广,行泌尿器官三期扫描,可进行多期、多层面重建,能很好地显示泌尿系统的病变,目前已被多家医院临床使用[2~4]。本文利用螺旋CT的轴位图像、多平面重建及三维重建显示的肾盂输尿管与CR静脉肾盂造影进行比较,以检测16层螺旋CT在泌尿系统成像检查中的优势。1材料与方法1.1一般资料2003-06—2005-06间,26例均行CR静脉肾盂造影与16层螺旋CT泌…     

经皮肾盂穿刺造影加逆行尿路造影诊断输尿管梗阻

目的探讨超声引导下经皮肾盂穿刺造影加上逆行尿路造影诊断输尿管梗阻的临床诊断价值。资料与方法 56例患者均经超声诊断为肾积水、输尿管积水,行静脉肾盂造影患侧肾、输尿管不显影,行逆行尿路插管造影剂不能充盈梗阻近端输尿管,后均行经皮肾盂穿刺造影加逆行尿路造影。结果 56例均经手术证实,其中13例肾盂输尿管交界处梗阻,11例输尿管上段梗阻,23例输尿管中段梗阻,9例输尿管下段梗阻。经皮肾盂穿刺造影加逆行尿路造影的诊断符合率100%。结论经皮肾盂穿刺造影加逆行尿路造影可清楚的显示肾盂和全段输尿管梗阻部位,弥补了静脉肾盂造影和逆行尿路造影的局限性。     

CR在静脉肾盂造影中的应用价值

静脉肾盂造影检查应用屏片系统方法,有时存在图像质量欠佳,造成诊断困难。随着计算机技术的发展,医学影像技术也进入数字化时代,计算机X线摄影(computed radiogra-phy,CR)提高了影像质量,应用于静脉肾盂造影(IVP)提高了诊断准确率。本文旨在探讨CR在IVP中的应用价值。1材料与方法本组100例中,男60例,女40例,年龄28~65岁。采用随机抽取普通屏/胶摄影技术的IVP 100例对照组,其中男63例,女37例,年龄30~70岁。设备:日本岛津500mA X线机所使用CR设备为Fujifilm FCR500图像处理系统和FUJI X湿式激光相机。采用泛影葡胺注射液对比剂,静…     

PACS系统下静脉肾盂造影的改进性研究

目的研究PACS下改进型静脉肾盂造影技术的应用价值。方法对200例静脉肾盂造影(其中传统静脉肾盂造影92例,传统大剂量肾盂造影8例,改进型静脉肾盂造影100例)进行回顾性分组比较分析。结果改进型静脉肾盂造影技术比传统普通剂量静脉肾盂造影技术缩短压迫时间9~11min;其造影剂用量与传统普通剂量静脉肾盂造影技术相同。结论改进型静脉肾盂造影技术优于传统普通剂量静脉肾盂造影技术;也优于传统大剂量静脉肾盂造影技术。     

多层螺旋CT尿路造影在泌尿系先天畸形的诊断价值

泌尿系先天畸形种类繁多,影像检查以往主要依靠B超、静脉肾盂造影(intravenous pyelography,IVP),对显示其解剖、形态和功能方面的改变存在局限性。CT尿路造影(CTurography,CTU)是经静脉注入对比剂后,由于肾脏的分泌功能使得对比剂在肾盏、肾盂、输尿管和膀胱内充盈,利用CT对受检部位进行连续扫描,将获得原始图像经计算机处理后     

64排螺旋CT静脉造影诊断下肢静脉血栓性病变

目的:探讨64排螺旋CT静脉造影(CTV)诊断下肢静脉血栓性病变的临床价值。材料和方法:下肢多层螺旋CT静脉造影(MSCTV)检查12例,同期均做下肢静脉Dopp ler超声(US)检查;其中1例同时进行了肺动脉CT血管造影,并于延迟2m in时行间接法下肢静脉造影检查。病例均采用5mm层厚和层间距行踝关节至髂骨上缘水平的增强CT扫描,并获得原始图像,图像经1.25mm层厚和50%的重叠处理后传送至工作站进行图像后处理。结果:64排螺旋CTV诊断下肢深静脉血栓(DVT)11例,诊断下肢慢性静脉功能不全1例,同时合并肺栓塞1例。以US作对照,64排螺旋CTV显示股静脉和腘静脉血栓的敏感性为100%,特异性98.6%。MSCTV上DVT表现为静脉腔内不规则低密度充盈缺损,慢性静脉功能不全表现为深静脉边缘不规则且于延迟2m in扫描见其远端引流静脉区造影剂点状残留。结论:64排螺旋CTV在显示股腘静脉血栓与US具有同等价值,MSCTV可作为下肢静脉血栓性病变诊断的常规检查方法。     

原发性输尿管癌的影像学诊断(附31例报告)

目的　探讨影像学对原发性输尿管癌的诊断价值。方法　静脉肾盂造影 逆行肾盂造影 2 1例 ,超声检查 2 5例 ,CT检查 14例。结果　输尿管癌在静脉肾盂造影和逆行肾盂造影表现为不规则充盈缺损 ;超声显示为大小不等、形态不规则实性结节 ,突向膀胱的肿瘤可呈菜花状 ;CT显示为大小不等、密度不均、形态不规则软组织肿块。结论　静脉肾盂造影、逆行肾盂造影、B超、CT互相结合 ,可提高输尿管癌的诊断水平     

大剂量静脉肾盂造影尿路各段显影探讨

回顾性分析我院十年来采用大剂量静脉肾盂造影,应用改变体位或延时摄片,使尿路各段显影。大剂量静脉尿路造影简便易行,同时结合改变体位以及延时摄片,能够较好的显示常规造影显示不清的扩张输尿管及其远端结石的部位和形态,对定位的定性诊断具有较大的临床价值;1资料、方法及原理设备:x—500型X线机、菲利浦CR系统、富士激光相机。1.1一般资料:我院自1996年3月至2006年3月行静脉尿路造影843例,其中男性为512例,女性为331例,40岁以上为487例,40岁以下为356例,同时对每位病人做详细记录,如碘过敏试验;志愿书签字;诊断意见;过敏反应及抢救措…     

输尿管囊肿的X线与超声诊断（附23例分析）

目的：探讨X线与超声对输尿管囊肿的诊断价值。方法：回顾性分析了23例输尿管囊肿的静脉肾盂造影（IVP）及超声检查资料,其中男性1例,女性12例;年龄2个月－43岁,平均年龄20．6岁。23例均行静脉肾盂造影、B超检查,2例行膀胱造影,1例行彩色多普勒超声检查,1例CT检查。结果：全部病例均经手术病理证实。左侧9例,右侧7例,双侧7例。静脉肾盂造影显示膀胱内边界清晰的充盈缺损16例,5例呈“眼镜蛇头”征,诊断正确率为91．3％（21／23）。B超显示囊肿呈类圆形无回声暗区23例,形态可随排尿而改变,诊断正确率为100％（23／23）。结论：静脉肾盂造影结合超声检查诊断输尿管囊肿可靠性高,二者相互弥补,可对此病作出正确诊断。     

CR在儿童静脉肾盂造影中的应用价值

目的探讨计算机X线摄影(CR)系统在儿童静脉肾盂造影(IVP)检查中的应用价值。方法对45例儿童分别采用传统屏/片及CR进行IVP检查,并对比二者间诊断符合率的差异。结果CR能较好地显示儿童泌尿系统病变,最大限度地保证照片的质量,诊断符合率为86.7%;而传统屏/片诊断符合率仅为59.1%。结论CR对儿童泌尿系统疾病的诊断具有重要价值。     

Does replacing intravenous pyelography with noncontrast helical computed tomography benefit patients with suspected acute urolithiasis?

OBJECTIVE: To determine if replacing intravenous pyelography with noncontrast helical computed tomography (NHCT) scanning of the abdomen for the investigation of suspected acute urolithiasis results in shorter stays in the Emergency Department, reduced hospital admissions or fewer interventions. METHODS: A retrospective review of the charts of all patients who were discharged from the Emergency Department with a diagnosis of acute urolithiasis or renal colic was conducted. Length of stay, hospital admissions and the number of therapeutic interventions were compared for the 5-month period before and the 5-month period after the implementation of NHCT scanning of the abdomen as the primary investigation of suspected acute urolithiasis. RESULTS: Of 230 cases reviewed, 119 met all of the inclusion criteria (61 in the intravenous pyelography group and 58 in the NHCT group). No significant differences were found between the 2 groups on median length of stay in the Emergency Department (7.6 h v. 6.2 h), hospital admission rates or post-test therapeutic interventions. CONCLUSIONS: Replacing intravenous pyelography with NHCT scanning for the investigation of suspected acute urolithiasis does not result in significantly shorter stays, reduced hospital admissions or fewer interventions for patients.     

输尿管非结石性梗阻肾积水影像特征分析

目的　分析输尿管非结石梗阻性肾积水的影像特征 ,提高对其的识别能力。方法　根据静脉肾盂造影、逆行尿路造影结果 ,对自 1997-0 1～ 2 0 0 4-0 2经手术和病理证实的输尿管非结石性梗阻肾积水 5 7例的影像及病理资料进行对照分析。结果　中、重度肾积水 47例 ,占 82 .5 % ,其中重度肾积水 2 3例中 ,输尿管肾盂高位连接 12例 ,低位连接 8例 ,输尿管局限狭窄的发病率为85 .1% ,其中输尿管多发和 /或双侧输尿管狭窄的发病率为 2 2 .0 % ,其它原因所致输尿管狭窄的发生率为 14 .9%。结论　输尿管非结石性梗阻的病因具有多样性 ,肾积水的不同影像改变与输尿管病变位置不同密切相关。当一侧肾为重度积水 ,另一侧肾盂表现为“壶腹”型肾盂时应注意排除双侧输尿管存在病变的可能性     

MR pyelography in 115 patients with a dilated renal collecting system

Purpose: To evaluate the accuracy of MR pyelography in the assessment of hydroureteronephrosis.Material and Methods: One hundred and fifteen patients, with variable degree of hydroureteronephrosis demonstrated by US and urography were subjected to MR pyelography obtained by means of two ultra-fast sequences.Results: Of the 228 kidneys examined, the collecting systems of 130 kidneys were dilated and correctly identified on MR pyelography, with only 2 false-positive results. The specificity of MR pyelography in detecting hydronephrosis was 98%. Accuracy in revealing level of obstruction was 100%. Sensitivity in detecting stones, strictures and congenital ureteropelvic junction obstructions was respectively 68.9%, 98.5% and 100%.Conclusion: MR pyelography can rapidly and accurately depict the morphological features of dilated urinary tracts with information regarding the degree and level of obstruction, without using contrast medium or ionizing radiation.     

先天非结石梗阻性肾积水影像诊断与病理基础

目的:回顾分析输尿管先天非结石梗阻性肾积水影像特征,提高对肾积水致病原因及输尿管无病变侧肾继发性改变特征的识别能力。方法:根据静脉肾盂造影、逆行肾盂造影、B型超声波及CT检查结果,经手术和病理证实的输尿管先天非结石梗阻性肾积水86例进行对照研究。结果:中、重度肾积水占86.0%,致病因素中输尿管狭窄占83.7%,其中一侧输尿管多处狭窄和(或)双侧输尿管狭窄占20.9%。肾积水的不同影像特征与输尿管梗阻的部位不同有关,轻度肾积水的肾盂改变类似"壶腹"型肾盂。结论:先天非结石梗阻性肾积水的病因多样,但多伴有输尿管狭窄。输尿管狭窄具有单侧多发及双侧同时发病的特点。一侧肾重度积水时,另一侧肾盂改变注意不要误诊为"壶腹"型肾盂。输尿管狭窄的定位诊断以逆行肾盂造影与静脉肾盂造影相结合为首选。     

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     

原发性输尿管息肉的X线表现

目的:提高对输尿管息肉X线表现的认识。方法:收集病理证实的原发性输尿管息肉13例,所有病例均行IVP检查,9例进行逆行性尿路造影。结果:85%(11/13)病变位于输尿管中上段、肾盂输尿管交界部及肾盂,IVP和逆行性尿路造影显示梗阻段输尿管扩张,其内可见充盈缺损影,其形态在不同时间的照片上可发生变化。结论:输尿管息肉的X线表现有一定的特征性,IVP和逆行尿路造影是发现和诊断输尿管息肉的常用方法,尤其是逆行尿路造影能够提高诊断的准确性。     

先天性巨输尿管症的X线与超声诊断(附19例分析)

目的：探讨X线与超声对先天性巨输尿管症的诊断价值。方法：回顾性分析了19例先天性巨输尿管症的静脉肾盂造影(IVP)、尿路逆行造影及超声影像资料。19例先天性巨输尿管症均进行了尿路造影和超声检查。其中3例术前做了CT检查，本组病例均经手术及病理证实。结果：巨输尿管症以其下端管腔无机械性梗阻的相对狭窄和狭窄段以上显著性扩张为特征。成人的扩张多不延及肾盂肾盏，小儿多数病例有肾盂肾盏扩张积水表现。早期扩张的下段可呈“纺锤状”或“杵状”。尿路造影透视和超声实时观察时，可见扩张输尿管蠕动频率减慢、幅度增大、向下传递间断。结论：超声因其具有诸多优点，可作为诊断巨输尿管症的首选的筛查方法。尿路造影检查，正确诊断率高，为本症术前的必查项目。两种检查方法联合应用可优势互补。     

Iohexol does not influence the levels of blood serum cation electrolytes during intravenous pyelography

PURPOSE: The influence of the nonionic contrast agent iohexol on blood pH and the cation electrolytes Ca, Na, K and Mg was studied in vivo in humans during the intravenous pyelography. MATERIAL AND METHODS: A population of 28 patients without renal function impairment or electrolyte imbalance was divided into two equal groups. The first group received an intravenous injection of 0.6 mL Omnipaque per kg of body weight (0.388g iohexol/kg and 0.18 g iodine/kg). The second group received a double dose of Omnipaque (1.2 mL iohexol/kg; 0.776g iohexol/kg and 0.36g iodine/kg). Blood samples (5 mL) were taken before the injection of the contrast medium and 5, 10 and 20 minutes (marking the end of the examination) after the injection. Blood pH was also determined immediately after each sample collection, while electrolytes were measured in the laboratory. Systolic and diastolic blood pressure were also determined simultaneously with each sample collection using a mercury manometer. RESULTS: Iohexol in simple and double doses did not have any statistically significant effect either on blood pH or on blood serum electrolytes during intravenous pyelography. Blood pressure, both systolic and diastolic, remained stable in all the patients during the examination. CONCLUSIONS: Our results show that the nonionic contrast medium iohexol at the doses used in routine intravenous pyelography does not have any influence on blood pH and serum cardioactive cation electrolytes in humans. An electrolyte imbalance is always a risk factor that may contribute to the development of cardiovascular side effects. This factor is eliminated when iohexol is administered intravenously instead of an ionic agent.