螺旋CT尿路成像的临床应用价值

The clinical application of spiral CT urography

目的:探讨螺旋CT尿路成像(SCTU)的临床应用价值。方法:应用螺旋CT对120例经临床和病理证实的泌尿道病变患者做平扫及四期增强扫描,并作曲面多平面重建(MPR)和SCTU重建,观察SCTU显示和诊断泌尿道病变的能力,并与其他检查技术及手术病理结果进行比较。结果:99.2%的患者SCTU结合轴位及曲面MPR能很好地三维立体显示泌尿道病变的部位、大小、形态和分布范围及尿路梗阻的情况;101例手术患者,泌尿道病变在螺旋CT图像上的表现与手术所见有很好的一致性。SCTU能显示部分病变的特征,可作为轴位和MPR图像的补充,并可弥补其他影像学检查的不足。结论:SCTU对泌尿道病变的显示和诊断有优越性,具有很高的临床应用价值,但必须密切结合多期轴位和MPR图像,才能对病变做出全面、准确的诊断。

Objective： To evaluate the clinical applications of spiral CT urography （SCTU） in the urinary tract abnormalities. Methods： Procontrast and four-phase postcontrast helical CT scans were performed in 120 patients with urinary tract diseases confirmed by clinic and pathology, and the curved mulfiplanar reformation （MPR） and SCTU images were generated from the volumetric data. The ability of SCTU in detecting and diagnosing of urinary tract diseases was investigated. The results were then compared with the findings of the other imaging techniques and surgery. Results： Combining with axial and curved MPR images, the location, size, morphology, extension and the urinary obstruction of the urinary tract diseases could be three-dimensionally demonstrated in 92.2% cases. The findings of urinary tract lesion on helical CT images corresponded well with those of surgery in 101 cases, SCTU was useful in displaying the some characterizations of the urinary tract abnormalities, and could compensate for some disadvantages of the axial, MPR images and other imaging techniques. Conclusion： SCTU has obvious advantage in the detection and diagnosis of the urinary tract abnormalities, and it can play an important role in the clinical work, but SCTU should be nearly combined with the multiple phase axial and MPR images to provide comprehensive information about the urinary tract abnormalities.