CT仿真膀胱镜临床应用价值探讨

Clinical Application of CT Virtual Cystoscopy

目的 总结螺旋CT仿真膀胱内镜 (CTVC)临床应用结果 ,探索其在临床应用中的意义。资料与方法 对临床具备指征的一组患者 ,在膀胱排空后静脉推注碘对比剂 ,待膀胱充盈后行膀胱区域的薄层螺旋CT扫描 ,将采集的数据转至工作站行后期处理。应用三维导航软件 (NavigatorSmooth)重建仿真内镜图像 ,供诊断观察。全部病例均有双盲纤维膀胱内镜 (FC)对照检查资料 ,并将两种检查结果结合部分手术、病理结果作对照分析。结果 本组 5 6例CTVC ,其中未见异常 7例 ,FC发现 1例为膀胱结石 ,余 6例正常 ,符合率 85 .7% (6 / 7) ;CTVC诊断膀胱肿瘤2 9例 ,FC及 /或手术证实 2 8例 ,另 1例系前列腺肥大 ,符合率 96 .5 % (2 8/ 2 9) ;CTVC诊断良性改变 (憩室、结石、囊肿、外压等 ) 2 0例均与FC相符 ,符合率 10 0 % (2 0 / 2 0 )。结论 CTVC在显示膀胱腔内累及膀胱壁的改变方面具有较高的敏感性 ,不失为一种非侵入性诊断方法 ,具有较好的临床应用价值。

Objective To evaluate CT virtual cystoscopy (CTVC) in the clinical practice.Materials and Methods Fifty six cases were included in this study. Iodine contrast was intravenously injected after the bladder was voided. Thin slice spiral CT scanning of the bladder area was started when the bladder became filled with contrast media. By using 3D Navigator Smooth software, CTVC images were obtained. With double blind method, the findings in all cases were compared with the fibro cystoscopic (FC) and surgical results.Results On CTVC no abnormality was found in 7 cases, of which cystolith was found in one and no abnormality in 6 cases by FC, with a coincidence rate of 85.7% (6/7). Of 29 cases with CTVC proved vesical tumor, the diagnosis was confirmed by FC and/or surgery in 28, and the coincidence rate was 96.5% (28/29). The remaining case was prostatic hyperplasia. Complete coincidence between CTVC and FC was seen in 20 cases with benign cystic lesions, including vesical diverticulum, calculus, cyst, external compression, etc.Conclusion CTVC is highly sensitive in displaying the vesical lesions. Being a new and non invasive technique, CTVC is very helpful in the diagnosis of vesical diseases, both benign and malignant. It is of great value in the clinical practice.