多层螺旋CT在泌尿生殖瘘诊断中的应用价值

目的探讨多层螺旋CT尿路成像（multi—slice spiral computed tomography urography，MSCTU）在泌尿生殖瘘诊断中的临床应用价值。方法回顾性分析经256层螺旋CT检查的临床疑诊泌尿生殖瘘病变18例的临床资料，采用原始轴位图像及后处理多平面重建（MPR）技术，结合临床对影像学检查进行分析并做出诊断。结果18例中明确诊断为膀胱阴道瘘13例，共有16个瘘口，直径2．1～7．4mm；输尿管阴道瘘5例，瘘口5个，直径3．4～5．1mm。膀胱阴道瘘位于近尿道内口三角区10例，近输尿管口3例，输尿管间嵴2例，膀胱底部1例。输尿管阴道瘘均发生在输尿管下段3．0cm以内。结论应用MSCTU行泌尿生殖瘘检查，可清晰显示瘘口的位置、大小及与周围组织结构的关系，为临床手术治疗提供准确的影像学依据。

The Value of Multi-slice Spiral CT in Diagnosis of Genitourinary Tract Fistulas

Objective To investigate the clinical significance of Multi-slice spiral CT Urography in displaying genitourinary tract fistulas.Methods 18 patients undergoing urography by 256-slice helical CT were analyzed retrospectively.Axial images and multi-planar reconstruction images were analyzed and diagnosis was made according to the clinical data.Results 13 out of the 18 cases were confirmed with vesicovaginal fistula,and the diameters of 16 fistulaes were 2.1~4.4 cm.5 cases were uretervaginal fistula,and the diameters of 5 fistulaes were 2.4~5.1 cm.10 patients had vesicovaginal fistula in triangular area of meatome,3 near to ureterostoma,2 in ureter intermediate carina and 1 at base of bladder.Vesicovaginal fistula occurred at 3.0 cm of ureter hypomere.Conclusion 256-MSCTU can clearly reveal the location,size of genitourinary tract fistulas and relationship with which surrounding tissue can be displayed.This technique can provide additional information for surgery.