螺旋CT在输尿管结石诊断中的应用价值

目的:探讨螺旋CT在输尿管结石诊断中的应用价值。方法:对51例临床可疑输尿管结石而常规B超、KUB、IVU等检查未确诊者,均未口服造影剂直接螺旋CT平扫,5例平扫后静注76%泛影葡胺60ml,延迟10～15s增强扫描,11例将获得的容积图像行输尿管多平面重建。结果:平扫确诊45例,可疑结石6例,其中5例经增强CT延迟扫描确诊,另1例经输尿管重建确诊。11例输尿管多平面重建成像均清楚地显示输尿管全程,同时显示结石大小、形态、位置和输尿管梗阻扩张程度及范围。结论:螺旋CT除直接显示高密度结石及其部位和大小外,还可显示输尿管梗阻扩张程度等继发征象,增强CT延迟扫描有助于鉴别腹膜后其他高密度影,输尿管多平面重建可获得良好的输尿管成像,弥补轴位图像不足,对输尿管结石诊断、鉴别诊断及治疗均有重要的临床应用价值。

The clinical value of helical CT for ureteral calculi

Objective:To evaluate the clinical value of helical CT for ureteral calculi.Methods:51patients suspected ureteral calculus on clinic yet with negative on B ultrasonic graphy, KUB and IVU were examined with helical CT without administration of contrast medium. 5 patients of all underwent additional enhancement scan,and 11 patients' images were reformatted.Results:All the patients showed ureteral calculi with high-density shadows on CT plain scan,but only 45 could be diagnosed from plain scan. 5 cases were confirmed by enhancement scan. All the reformatted CT displayed the entire course of ureter clearly including the stone size,shape,location ,the obstruction degree of ureter. Conclusions: The diagnosis of ureteral calculi was made on helical CT views by demonstrating a ureter calculus directly and other secondary CT signs, The MPR views also demonstrated the ureter and the structures around clear to aid greatly in identifying and choosing the therapy. As an imaging tool,Helical CT has potential for the ureteral calcul diagnosis. It is not only very helpful to diagnose ureteral calculi but also palys an important guiding role for the treatment.