640层CT动态容积排泄性膀胱尿道造影术对前列腺增生梗阻的研究

目的探讨640层CT动态容积排泄性膀胱尿道造影对前列腺增生(BPH)继发膀胱出口梗阻(BOO)的诊断价值。方法回顾分析2013年12月至2018年12月云南省第二人民医院就诊并接受CT排泄性膀胱尿道造影扫描的男性患者资料,经临床诊断为BPH继发膀胱出口梗阻BOO的患者60例,临床检查无膀胱出口梗阻的34例受检者作为对照组。所有数据导入minics生成三维图像,选取排尿期间尿道体积及截面最大一组图像进行测量。数据采用ROC曲线下面积分析和Logistic回归多变量分析。结果 Logistic回归多变量分析结果显示前列腺后叶厚度及尿道长度的改变是诊断前列腺增生导致梗阻的独立、有效指标。ROC曲线分析提示前列腺后叶厚度、尿道长度ROC曲线下面积分别为:0.984、0.961,诊断前列腺增生导致梗阻的敏感性分别为100%,93.1%,特异性分别为86.7%,93.3%。结论 640层CT动态容积排泄性膀胱尿道造影可以获得BPH患者在排尿过程中膀胱及后尿道全程影像数据,具有无创、清晰及可以任意方位重组观察等优点,能量化及直观判断BPH导致BOO引起的后尿道的形态改变。

The study of 640-slice CT voiding urography of posterior urethra in the diagnosis of bladder outlet obstruction caused by benign prostatic hyperplasia

ObjectiveTo investigate the value of 640-slice dynamic computed tomography voiding urography(DVCT VUPU) of posterior urethra in the diagnosis of bladder outflow obstruction (BOO) caused by benign prostatic hyperplasia(BPH). MethodsThe data of 60 patients with clinically diagnosed BOO due to BPH and 34 cases without BOO as control group from December 2013 to December 2018 were analyzed retrospectively. All cases underwent DVCT-VUPU in the same period. The data of all phases were imported into minics. The 3D images of the lower urinary tract with the largest volume were marked. The influence was analyzed by logistic regression and receiver operating characteristic(ROC) curve. ResultThe urethra length and dimension of posterior lobe of prostate gland was independent and valid index for diagnosis of BOO due to BPH. The area under curve(AUC) of dimension of posterior lobe of prostate gland, urethra length was 0.984, 0.961, respectively, The susceptibility to diagnosis of BOO due to BPH was 100% and 93.1%, and the specificity was 86.7% and 93.3%, respectively. Conclusion640-slice DVCT voiding urography could display the whole urethra and bladder during the voiding scanning in patients with BPH, which showed advantages including non-invasive, clear images and images could be observed in any direction during the voiding scanning. It provided a technique to make quantitative and comprehensive diagnosis of BOO secondary to BPH.