磁共振尿路成像临床应用

目的 探讨磁共振尿路成像(MRU)的临床应用价值。方法 利用PHILIPS T5-NT 0.5T超导型MR扫描机,采用快速自旋回波(TSE)序列重T_2加权技术,对52例患者作MR尿路成像,行最大信号强度投影(MIP)处理,所有患者均先行常规MR扫描。结果 52例中,尿路梗阻扩张26例,其中:肾盂-输尿管交界段狭窄7例,输尿管癌4例,输尿管结石6例,输尿管炎性狭窄4例,输尿管外压1例,膀胱癌2例,神经源性膀胱2例。MRU显示尿路梗阻扩张正确率达100％,对梗阻定性诊断有3例错误。无尿路梗阻17例,其中肾癌3例,肾盂癌2例,肾血管平滑肌脂肪瘤1例,肾囊肿9例,马蹄肾1例,一侧肾缺如1例,均由MRI和MRU相结合确诊。另有9例患者呈现不同程度肾盂积水,未见尿路梗阻征象,其中:6例结合临床诊断为肾盂肾炎。52例中,部分病例与B超、IVU、CT扫描结果进行了比较。结论 MRU为一有效安全无创的影像检查技术,特别适用于肾功能不良和有IVU禁忌症者,对确定尿路梗阻扩张,梗阻的定位、定性有重要的应用价值。MRU和MRI相结合能对泌尿系统疾病的诊断提供更为完整的诊断依据。但在实践中,应依据患者具体情况合理选用MRU检查。

Clinical application of MR Urography

Purpose To evaluate the clinical application of MR urography (MRU). Methods 52 patients were examined by MRU which was performed with heavily T2 weighted Turbo spin echo sequence. Results 26 patients with urinary tract obstructive disorders in 52 patients were found to be congenital ureteral stricture (7), ureteral carcinoma (4), calculus (6), benign stricture (4),ureteral obstruction caused by extrinsic disease (1), bladder carcinoma (2), and neurogenic bladder (2). The accuracy of MRU for revealing the obstruction of urinary tract was 100 %. 3 patients were misdiagnosed for the cause of obstruction. 17 patients of non-urinary tract obstruction were found to be kidney carcinoma (3), renal pelvis carcinoma (2), angiomyolipoma (l),kidney cysts (9), horseshoe kidney (1), and solitary (1). The remaining 9 patients were demonstrated to be hydronephrosis, but non-evidence of urinary tract obstruction, pyelonephritis was presented in 6 patients combination with clinical. Result of part patients were compared with US, CT, IVU in 52 patients. Conclusion MRU is a safe, non-invasive and efficient imaging method. Especially this technique can be used in patients with renal failure. MRU has been proved to be efficient in detecting the level of obstruction and permitting an analysis of type of obstruction.