多层螺旋CT尿路造影与逆行肾盂造影在诊断输尿管梗阻性疾病中的价值对比

目的：探讨多层螺旋CT尿路造影（CTU）和逆行肾盂造影（RP）在诊断输尿管梗阻性疾病中的准确性和应用价值。方法：对40例输尿管梗阻性病变患者均先后行CTU和RP，以输尿管镜或开放手术或（和）病理检杏结果为标准，两者进行对照分析。结果：40例输尿管梗阻性疾病患者中。肿瘤6例，先天性狭窄9例，结石8例，良性狭窄17例。CTU和RP诊断准确率均为92．5％（37／40）（P〉0．05），病因诊断符合率分别为90％（36／40）和57．5％（23／40）（P〈0．05）。结论：CTU对输尿管梗阻性病变诊断的准确率和病因符合率高，较RP有更好的病因诊断价值，可作为IVU显影不良者的首选补充检查方法，但仍存在一定局限性，需选择性应用。

Comparison of Multi Detector Spiral CT Urography and Retrograde Pyelography in the Diagnosis of Ureteral Obstructive Diseases

Objective： To compare the accuracy and diagnostic value of muhi detector spiral CT urography （CTU） and retrograde pyelography （RP） in patients with obstructive ureteral diseases. Methods：40 patients with obstructive ureteral lesions were examined with both CTU and RP, and the diagnostic results with these two modalities were individually and correlatively compared with the findings from the open surgery or ureteroscopy and or pathology. Results： There were 6 cases of ureteral tumors, 9 cases of congenital ureteral stricture, 8 cases of ureteral calculi and 17 cases of benign stricture in all 40 cases. The accuracy rates of CTU and RP were both 92.5% （37/40）（P〉0.05）, however, CTU had higher accuracy than RP in etiology diagnosis, with 90% （36/40） in CTU and 57. 5% （23/40） in RP （P〈0.05）. Conclusions：Both CTU and RP provide accurate diagnosis of the level of the obstruction. However, CTU was higher than RP in accuracy of etiological diagnosis. CTU enables to become the first supplementary examination when IVU can not display the obstructed ureter clearly. However, there are still some shortages on CTU, and the clinical application of CTU needs to be further investigated.