输尿管病变多层螺旋CT及后处理技术价值评价

Diagnostic Value of Multi-slice CT and Post-processing Techniques in Ureteral Lesions

目的:探讨多层螺旋CT及后处理技术在输尿管病变中的应用价值。方法:前瞻性搜集输尿管病变106例,其中结石54例、肿瘤34例、结核7例、先天畸形5例、良性狭窄2例、膀胱尿潴留致输尿管扩张4例,行多层螺旋CT扫描(MSCT)和后处理重组,观察后处理重组技术显示和诊断输尿管病变的能力。结果:106例后处理重建图像均能清楚显示输尿管病变的部位、范围、形态、周围情况以及病变上方输尿管肾盂梗阻扩张程度。曲面重组(CPR)能在一个平面上显示输尿管全程,对肾功能差、无功能肾及严重梗阻致输尿管不显影者价值更大;最大密度投影(MIP)和容积再现(VR)图像类似于静脉尿路造影(IVU),能立体显示病变。结论:MSCT扫描及后处理技术对输尿管病变的显示和诊断具有一定优势,尤以CPR价值最大,有望代替KUB和IVU成为一种常规检查。

Objective：To investigate the applieation value of multi-sliee CT （MSCT） and post-processing techniques in ureteral lesions. Methods： 106 cases with ureteral lesions were prospectively collected in the study, including ureteral stones （ n= 54 ）, tumors （ n=： 34 ）, tuberculosis （ n=： 7 ）, congenital deformity （ n = 5 ）, benign stenosis （ n = 2 ）, and ureteral dilatation caused by bladder retention of urine （n=4）. All patients had undergone MSCT scanning and post-processing reconstruction,the demonstration and diagnostic capabilities of post-processing techniques were analyzed. Results： All postprocessing reformation images could exhibit the location,range,shape and adjacent structure of ureteral lesions and the degree of ureteropelvic obstruction above the lesions. Curved planar reformation （CPR） could clearly display the whole range of ureter in one plane, which was of great value to renal dysfunction, function-losing kidney and underdeveloping ureter caused by severe obstruction. Maximum intensity projection （MIP） and volume rendering （VR） images, similar to intravenous urography （IVU）,could demonstrate the ureteral lesions in stereo display. Conclusion： MSCT scanning and post-processing techniques can supply valuable information in the demonstration and diagnosis of ureteral lesions, especially for CPR,and will serve as a routine examination method instead of KUB and IVU.