16层螺旋CT尿路三维重建在泌尿系梗阻性疾病诊断中的价值

目的:探讨16层螺旋CT低剂量尿路三维成像在泌尿系梗阻性病变诊断中的价值.方法:参照IVU检查方法,对 91例B超、KUB及IVU未明确病因的泌尿系梗阻性病变病例,行16层螺旋CT扫描,利用后处理技术对扫描资料进行三维重建处理.结果:16层螺旋CT尿路造影清晰显示泌尿系的解剖结构,以及病变和尿路之间的空间关系.91例患者中,泌尿系结石51例,肾盂输尿管重复畸形10例,肾位置异常6例,巨输尿管1例,腔静脉后输尿管3例、输尿管良性狭窄11例,前列腺囊肿伴右肾缺如1例,输尿管结核4例,腹膜后肿瘤压迫输尿管4例,结石和肿瘤病例均经手术或病理证实.CT诊断与临床诊断符合率100%.结论:16层螺旋CT尿路三维成像对显示泌尿系梗阻性病变快捷、安全可靠,可作为诊断泌尿系梗阻性疾病的首选影像学方法之一.

Clinical Value of 16-slice Spiral CT with 3-dimentional Reconstruction Technique in the Diagnosis of Urinary Tract Obstructive Diseases

Objective:To evaluate the 16-slice spiral CT with 3-dimensinal reconstruction technique in the diagnosis of urinary tract obstructive diseases.Methods:In 91 cases having urinary tract obstructive diseases which cause could not be diagnosed by ultrasonography,kidney-ureter-bladder plain film and intravenous urography,16-slice spiral CT before and after iv injection of 40ml 300 Omnipaque (7min,10min,30min delay) was performed.The acquired data were post-processed using 3-dimensional reconstruction technique.Results:The whole course of urinary tract,location and the cause of obstruction could be clearly demonstrated by 16-slice spiral CT delayed urography.Of the 91 cases,there were urinary calculi (n=20),duplex renal pelvis and ureter (n=10),mal-position of kidney (n=6),giant ureter (n=1),retrocaval ureter (n=3),benign stricture of ureter (n=11),prostate cyst accompanied with right kidney agenesis (n=1),ureter tuberculosis (n=4) and ureter compressed by retroperitoneal neoplasm (n=4).All of the patients with ureterolith and neoplasm were confirmed by surgery or pathology.The coincidence rate of CT and clinical diagnosis was 100%.Conclusion:16-slice spiral CT with 3 dimensional reconstruction technique is safe,reliable,convenient and fast,which might be used as the first choice of imaging technique in the diagnosis of urinary tract obstructive diseases.