64层容积CT尿路造影对泌尿系统先天畸形的诊断价值

目的 探讨64层容积CT尿路造影(VCTU)对泌尿系统先天畸形的诊断价值.资料与方法 66例经手术、输尿管镜或临床证实的泌尿系统先天畸形患者行VCTU检查,并行容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)及曲面重组(CPR)后处理,获得尿路重建图像.结果 66例患者中(2例为多发畸形),肾盂输尿管重复畸形32例,马蹄肾7例,肾旋转不良6例,肾盏憩室5例,先天性肾盂输尿管连接处狭窄5例,先天性巨输尿管1例,输尿管开口异位1例,腔静脉后输尿管1例,输尿管囊肿3例,膀胱憩室7例.VCTU图像清晰、立体感强,可多角度观察尿路,诊断正确率达100％.结论 VCTU通过VR、MIP、MPR、CPR图像能准确显示泌尿系统先天畸形及其伴发病变,提高了病变检出率和诊断正确率,可作为诊断泌尿系统先天畸形的首选方法.

Application of 64-slice Volume CT Urography in the Diagnosis of Urinary Congenital Malformation

Purpose To evaluate the diagnostic value of 64-slice volume CT urography(VCTU) in the urinary congenital malformation.Materials and Methods 66 cases with urinary congenital malformation confirmed by surgery or ureteroscopic findings undertook VCTU.The postprocessing images including volume rendering(VR),maximum intensity projection(MIP),multiplanar reconstruction(MPR),and curve planar reconstruction(CPR) were achieved.Results Among the 66 cases(2 cases with multi-malformation),there were 32 cases of duplication of renal pelvis and ureter,7 cases of horseshoe kidney,6 cases of renal malrotaion,5 cases of calyceal diverticulum,5 cases of ureteropelvic junction stenosis,1 case of congenital megaureter,1 case of ectopic ureter,1 case of retrocaval ureter,3 cases of ureterocele,and 7 cases of bladder diverticulum.The postprocessing images were clear and stereoscopic.The diagnostic accuracy of VCTU was 100%.Conclusion With the VR,MIP,MPR and CPR reconstruction techniques,VCTU can correctly display urinary congenital malformation and the associated diseases,which can improve the clinical detection rate and diagnostic accuracy of urinary congenital malformation.VCTU can be used as a preferred diagnostic method for urinary congenital malformation.