正常脐尿管及脐尿管病变的MSCT诊断

CT diagnosis of urachal normalities and abnormalities

目的：探讨多层螺旋CT（MSCT）对正常脐尿管及脐尿管病变的显示情况，提高对脐尿管及其病变的认识，指导临床合理选择检查方法。方法：收集腹部MSCT平扫或增强扫描病例228例，均对其脐尿管进行多平面重组（MPR）处理，按性别分为两组，观察正常脐尿管的显示率、长度、大小与性别的关系，按年龄段分四组（20岁以下，21～40岁，41—60岁，60岁以上），观察各年龄组脐尿管的显示情况并分析经手术病理证实的8例脐尿管病变的CT征象。结果：MSCT轴位图像结合多平面重组图像对脐尿管全程显示30例（30／228，女性8例，男性22例）；部分显示39例（39／228，女性13例，男性26例）；未见显示162例（159／228，女性75例，男性84例）。脐尿管长度为2．30—17．89cm，平均长度为13．84cm；底部前后径为2-11．0mm平均宽度为5．35mm；底部左右径为3．0—9．5mm，平均宽度为7．95mm。41—60岁组脐尿管显示率最高（37．8％），20岁以下组脐尿管显示率最低（13．3％）．脐尿管病变8例为脐尿管憩室5例（其中4例合并结石），脐尿管囊肿1例，脐尿管肿瘤1例，脐尿管未闭1例。结论：MSCT轴位图像结合多平面重组图像对各年龄组脐尿管的显示有明显差异性，且与年龄、性别有关，MSCT能明确脐尿管病变的部位和性质，是脐尿管病变的首选检查方法。

Objective：To analyze MSCT manifestations of urachal normalities and abnormalities and to improve the diagnostic value of urachal abnormalities so as to select the suitable examination. Methods： 228 cases with plain scan or two-phase enhancement scan of MSCT were selected, whose urachuses were analyzed with multiple planar reformation. All cases were divided into two groups by sex and into four groups （below th age of 20,21 to 40,41 to 60, and above 60） by age. To analyze the length, size, rate of normal urachus and findings of 7 cases with urachal abnormalities proved by surgery and pathology. Results： Urachus fully displayed with axial images combined with multiple planar reformation of MSCT were 30 cases（30/228, 8 females, 22 males）, 39 cases （39/228, 13 females, 26 males） were partially displayed, 159 cases （159/228, 75 females, 84 males） were not displayed. The length of urachus was from 2.30 cm to 17.89 cm, the average length was 13.84 cm, bottom length of urachus was from 2.00 cm to 11.00 can, average length was 5.35 cm, bottom width of umchns was from 3.00 cm to 9.50 cm, average width was 7.95 cm. The highest rate （37.8%） of urachns displayed was the group aged from 41 to 60, and the lowest （13.3%） was below 20. Other 8 cases were urachal abmormalities： Five cases of urachal diverticulum （four accompanied with calculus）, 1 case of simple umchal cyst, 1 case of patent urachus, and 1 case of urachal tumor. Conclusion：The rate of urachus displayed with axial images combined with multiple planar reformation of MSCT is different according to sex and age. The best way to diagnose urachal abnormalities is MSCT, which can easily identify the position and character of urachal abnormalities preoperatively.