多层螺旋CT尿路造影在泌尿系统病变诊断中的价值

目的：探讨多层螺旋CT尿路造影（MSCTU）对泌尿系病变的诊断价值。方法：收集经KUB、IVU检查单侧输尿管显示欠佳或不显影患者38例，健康志愿者4例，行CT平扫、肾脏增强双期扫描及尿路造影，将平扫及尿路造影资料传送至工作站，进行最大强度投影（MIP）、多平面重建（MPR）及容积重建（volume-rendering），获得完整尿路影像。结果：所有病例在14-2s内完成全尿路扫描。24例输尿管结石，重建图像能清晰显示结石位置及上段积水情况；2例肾肿瘤及1例输尿管切开取石术后患者显示输尿管内多发血块；2例术后输尿管粘连及肿胀至输尿管梗阻；1例结肠癌淋巴结转移侵犯输尿管；3例肾盂输尿管重复畸形清晰显示输尿管汇合部位；1例尿瘘可见尿湖位于输尿管中段，肾盂瘘口与之相连；1例先天性巨输尿管和1例腔静脉后输尿管完整显示其形态和走行。结论：多层螺旋CT具有超高速、大范围、薄层扫描能力，应用于尿路造影有其独特优势，可作为临床一种新的辅助诊断手段。

Multi-slice spiral CT urography in the diagnosis of urinary system diseases

Objective: To evaluate multislice CT urography (MSCTU) in diagnosis of urinary system disease. Methods:CT plain scan,renal dual phase enhanced scan and CT urography were performed in 42 cases respectively. All the cases had already received KUB and IVU examinations. The urinary passage images were reformed by means of MIP.MPR and VR. Results: The scanning of each case was finished within 14-22 seconds. The reconstructed images could display clearly the diseases and anomalies of the urinary tract,these included;ureteral stones and dilation of ureter and renal pelvis in 24 cases,blood clots in ureter and bladder after operation (n = 2). ureteral inflammation and adhesion led to ureteral obstruction (n=2) .invasion of ureter due to lymph node metastasis (n=l). duplication of ureter and pelvis with good demonstration of the confluence of ureter (n= 3) , ureteral fistula and resulting encapsulated urine collection (n= 1), congenital megaureter (n=1) and retrocaval ureter (n=l). Conclusion:MSCTU has obvious advantage in the diagnosis of urinary system diseases because of its ultra fast scan speed,big coverage and thin slice scanning ability. Therefore it can be used in the clinical work as a new assistant diagnostic method.