排尿法CT诊断前列腺增生的研究

目的：采用排尿法ＣＴ（ＭＣＴ）检查方法，评价增生的前列腺组织对尿道的压迫、对排尿功能的影响和膀胱的继发性改变。方法：将３２例患者分为二组：正常组１０例，增生组２２例。增生组又分为３个型，肿块型１４例，结节型３例，混合型５例。在注射造影剂后３０ｍｉｎ～１ｈ，进行排尿法ＣＴ检查。观察前列腺段尿道的形态改变及计算其截面积；记录排尿时间、排尿量；计算膀胱残余尿量及膀胱排尿指数；观察膀胱壁的形态改变。结果：正常前列腺段尿道有点圆形、椭圆形、圆形及三角形等数种形态，它们是不同排尿时相的表现。尿道后壁中央有精阜突出，尿道内口呈圆形。增生组表现为尿道受压，截面积变小和尿道移位、扭曲等，同时伴有排尿功能的改变和膀胱残余尿量的增加。肿块型增生时，尿道受压较严重，排尿时间明显延长。结节型增生对排尿时间影响不大。膀胱壁的继发改变有膀胱小梁形成及真性和／或假性憩室。结论：ＭＣＴ能揭示前列腺增生的病理过程——压迫尿道产生排尿不畅以及膀胱的继发病变，是一种较为理想的前列腺增生的检查方法

CT Diagnosis of Prostatic Hypertrophy During the Course of Micturition

Objective:To examine 32 cases of benign prostatic hypertrophy (BPH) with CT during the course of micturition in order to estimate the degree of narrow prostatic urethra(PU) and the changes of urination.Methods:The patients were divided into two groups,control group 10 cases and hypertrophic group 22 cases which was further divived into three types-mass type (14 cases),nodule type (3 case)and mixed type (5 cases).MTC was performed at half an hour or an hour after injection of contrast medium.The morphology of PU and bladder was observed.Voiding time and cystic residual urine volume was calculated.Results:The normal prostatic urethra was shown as needle-pin,circular,ellipsoid,triangle and so on,which were presented at the different duration of urination.The verumontamun was shown clearly at the posterior wall of the prostatic urethra.In hypertrophic group,the changes of the prostatic urethra included constriction or dislocation of urethra,decrease of urethral area,prolongation of voiding time and the increase of cystic residual urine volume.In mass type the prostatic uretaral constricted was severe and voiding time was prolongation obviously.In nodule type,voiding time was not affeted.The secondary changes of the bladder such as cystic trabeculation and diverticulum were also demonstrated.Conclusion:MCT is an ideal method for BPH.PU oppressed by hypertrophic prostate and secondary cystic changes can be demonstrated clearly with MCT.