CT尿路造影对非结石性尿路梗阻疾病的诊断作用

目的评价CT尿路造影(CTU)对非结石性尿路梗阻疾病的诊断作用。方法40例非结石性尿路梗阻病例给予实质期、分泌期增强螺旋扫描。分泌期数据经第2次重建后在工作站以三维方式获得CTU影像。结果40例中，24例良性梗阻呈轻度或重度积水。18例先天畸形CTU呈现各自特征；4例输尿管炎表现为鸟嘴样狭窄，2例前列腺增生可见膀胱后壁压迹。16例肿瘤患者梗阻端呈截断或锥状狭窄伴局部软组织影，12例尿路中度积水，4例重度积水。其中4例呈双侧积水。对6例一侧无分泌功能者，可采用最小强度投影等予以显示，并与对侧最大强度投影像等整合。结论CTU对非结石性尿路梗阻疾病的诊断具有良好的效果。

The effect of CT urography in the diagnosis of non-calculous urinary obstruction diseases

Objective To evaluate the diagnostic effect of CT urography (CTU) in patients with non-calculous obstructive diseases of urinary tract.Methods Forty cases with non-calculous urinary obstruction underwent helical CT during nephrographic and excretory phases.Three dimensional CTU was obtained with the reconstruction of excretory phase axial images through the workstation.Results 24 of 40 cases with benign obstruction had a slight or severe urinary dilation.Among them,18 congenital urinary malformations showed specific findings.Four ureteric inflammations revealed a gradual taper of the lumen just like a beak,and another two prostatic hypertrophy appeared oval impression upon the middle of the posterior bladder.Six intrinsic and 10 extrinsic tumors were seen irregular filling defects of the urinary tracts as well as soft tissue mass surrounding the obstructive site,accompanied by the middle urinary dilation in 12 cases and severe in four.Meanwhile,bilateral ureterohydronephroses were also found in four extrinsic tumors.In six patients with unilateral nonfunctioning urinary tracts,CTU could be imaged with minimum intensity projection (MinIP) and then be merged with contralateral maximum intensity projection (MaxIP).Conclusion CTU is an effective modality in the evaluation of non-calculous urinary obstruction diseases.