动态静脉尿路造影后螺旋CT尿路成像对输尿管梗阻的诊断价值

Diagnostic Value of Spiral CT Urography Following DIVU in Ureteral Obstruction

目的:研究动态静脉尿路造影(DIVU)后螺旋CT泌尿系成像(SCTU)对输尿管梗阻的诊断价值。方法:35例患者DIVU示单侧尿路显影不良及输尿管梗阻原因不明,行螺旋CT平扫、多平面重建和容积重建三维重建成像。所有病例均经手术病理证实。结果:35例患者DIVU后行SCTU,诊断输尿管结石18例,炎性狭窄4例,外压性狭窄4例,肿瘤3例,先天性狭窄3例,腔静脉后输尿管1例,双侧肾盂及输尿管重复畸形1例,不能确诊1例。结论:DIVU后SCTU是一种无创、可靠、有效检查方法,可明显提高输尿管梗阻性病变诊断准确性,具有很高的临床应用价值。

Objective. To explore the diagnostic value of spiral CT urography following DIVU. Methods. A total of 35 patients with unknown nature of ureteral obstruction and unilateral renal function was inadequate to allow visualization underwent SCT plain scan after DIVU. 3D images were reconstructed with MPR （Multiple plane reconstruction, MPR） and VR （volume rendering, VR）. All 35 cases were proved by surgical pathology. Results. Of all the 35 cases, 18 of stones, 4 of inflammatory constrictions, 4 of compressed stenosis, 3 of tumors, 3 of congenital constrictions, 1 of retrocaval ureter,and 1 of double kidney combined with ureteral malformation were diagnosed definitely SCTU following DIVU. But still there were 1 cases not be confirmed. Conclusion. SCTU following DIVU may be a noninvasive, reliable, effective examination technique. It could improve the diagnostic accuracy of ureteral obstruction disease and could be very great clinical value on diagnosis.