尿路梗阻性病变的MRU应用

目的 探讨磁共振尿路造影(MRU)技术对尿路梗阻性病变的诊断价值。资料与方法 对46例经B超发现尿路扩张患者采用重T2WI单次激发快速自旋回波(SSFSE)序列行MRU检查，其中41例行静脉肾盂造影(IVP)。结果 46例尿路梗阻性病变包括：良性狭窄19例，先天性异常10例，输尿管结核5例，输尿管癌3例，外在性病变4例，输尿管结石4例，膀胱病变1例。MRU均清楚显示尿路影像，能确定有无梗阻，展示梗阻端的形态和特征，对梗阻水平的定位及梗阻原因的定性均有较高的准确性，明显优于IVP检查。结论 MRU是安全、有效的非侵袭性影像检查方法，特别适用于IVP禁忌症和肾功能丧失者。可多方位、多角度成像，结合常规T1WI、T2WI可获得可疑部位的大量信息，以达到明确诊断目的。

Evaluation of MR Urography in the Diagnosis of Urinary Obstructive Diseases

Objective To evaluate MR urography (MRU) in diagnosing urinary obstructive diseases.Materials and Methods MRU with heavy T 2WI SSFSE was performed in 46 patients with dilated urinary tract demonstrated on B-sonography, additional intravenous urography (IVU) was carried out in 41. Imaging findings were analyzed and compared.Results The urinary obstructive diseases included benign stricture (n=19), congenital malformation (n=10), uretal tuberculosis (n=5), uretal carcinoma (n=3), extrinsic lesions (n=4), calculus (n=4) and bladder disorder (n=1). MRU well demonstrated the urinary tract. MRU was superior to IVU in displaying the site and shape of the obstruction and in determining the cause of obstruction. Conclusion MRU is an effective, safe and non-invasive imaging means for detecting urinary tract obstruction, especially for patients who has contraindications to IVU or suffers from renal dysfunction. A combination of conventional T 1WI and T 2WI can provide abundant information useful for the diagnosis.