磁共振尿路造影临床应用研究

目的：评估磁共振尿路造影（ＭＲｕｒｏｇｒａｐｈｙ，ＭＲＵ）显示肾和尿路病变与解剖结构的作用。材料与方法：３５例病人（尿路梗阻１８例，非尿路梗阻１７例，３１例经手术证实）。ＭＲＵ为冠状位快速自旋回波Ｔ２加权像，扫描前口服速尿并行尿路加压，使用交互式血管成像（ＩＶＩ）方法进行图像后处理。结果：ＭＲＵ提供了全部病人和正常人肾实质和肾集合系统高分辨率图像。全部尿路梗阻病变部位和肾盂积水及１例肾输尿管解剖畸形均清晰显示。非尿路梗阻病人（７０％）双侧输尿管均显示。结论：ＭＲＵ无射线辐射，无需用含碘造影剂，口服速尿和行尿路加压能有效地保证ＭＲＵ图像质量，适合尿路梗阻病变的检查。可清晰显示尿路梗阻部位，有助于定位、定性诊断，ＭＲＵ还能显示肾和尿路细微解剖结构，并反映其功能，是一种可选择的、有应用价值的泌尿系影像学新方法。

Clinical application of MR urography

Purpose: To evaluate the role of magnetic resonance urography (MRU) on depicting the lesion and anatomy of kidney and the urinary tract. Materials and methods: Thirty five patients (18 with urinary tract obstruction and 17 without obstruction) were examined with MRU and 31 of them were confirmed operatively. MRU was obstained with a heavily T 2 weighted fast spin echo pulse sequence, and acquired in the coronal plane. Peroral administration of furosemide and ureteral compression were given prior to imaging. Postprocessing of the raw images was performed with IVI software. Results: MRU provided high resolution images of parenchyma and collecting systems of kidney. Location of urinary tract obstruction and hydronephrosis were distinctly shown by MRU. Anatomic anomalies were depicted in one patient. In 70% of nonurinary tract obstruction patients bilateral ureters were shown. Conclusion: MRU has the potential advantages of being nonhazardous to human health from radiation and contrast media. Successful MRU can be effectively obtained with prescan peroral administration of furosemide and ureteral compression. MRU is recommended for the examination of urinary tract obstruction, and the orientation and the pathogenesis of the obstruction. Fine anatomical structural details and functions and urinary tract can be obtained with MRU. MRU as a new alternative method of urinary tract imaging technique is clinically valuable.