低张利尿剂对多层螺旋CT输尿管曲面重组的价值

The Value of Hypotonic Diuretics Drug for Ureter Curved Planar Reconstraction with Multislice Spiral CT

目的探讨使用低张、利尿药物后多层螺旋CT(MSCT)非增强扫描曲面重组(CPR)对输尿管病变的诊断价值。资料与方法搜集2006年2月至2007年10月行尿路MSCT扫描患者124例,随机分成2组,即常规平扫(A组)52例,男32例,女20例,平均42.8岁;注射低张利尿药物后扫描(B组)72例,男性44例,女性28例,平均37.6岁。Toshiba Aqulion 16层螺旋CT机,1.0×16准直宽度,螺距1.0,一次屏气后从肾上极扫描至耻骨联合上缘。层厚/间隔1 mm/0.8 mm重组,在Vitra 2后处理工作站上以横断面为参考平面,在冠状面或矢状面上做输尿管CPR。分别统计各组的两侧输尿管显示优良率,SPLM 3.0统计软件处理,秩和检验,α=0.05,P<0.05。结果A、B组间按Wilcoxon等级资料比较,u=4.478(界值2.58),P<0.01,低张利尿后MSCT平扫后的输尿管CPR优良率明显高于未予低张利尿组。A组内患健侧比较,Kruskal-Wallis法:Hc=2.179,P<0.05(界值1.96),差异有统计学意义。B组内患健侧比较,Hc=7.441,P=0.0242>0.05(界值1.96),差异无统计学意义。结论使用低张利尿剂后进行MSCT扫描CPR的方法能清楚地显示全程输尿管,是一种简单省时、相对禁忌证少、患者无痛苦、可重复使用的较佳检查方法。

Objective To explore the value of the hypotonic diuretics drug for the diagnosis of the ureter lesions by the noncontrast muhisliee spiral CT （MSCT） curved planar reconstruction （CPR）. Materials and Methods 124 cases received MSCT urography from Feb-2006 to the Oct-2007. All cases were randomly assigned into two groups, group A with routine examination in 52 cases, the group B with hypotonic diuretics drug in 72 cases. All cases were performed with Toshiba Aquiline 16 slice spiral CT, thickness/gap 1 ram/0.8 mm. The scan range from the upper part of the kidney to the pubic symphysis. Postprocess were performed at the Vitrea- Ⅱ workstation, regarded the axial image as the reference plane, the CPR was taken along the ureter tract. The numbers of different grades were calculated by both sides of the ureter. All the data were treated with the SPLM statistic software, rank sum test. （ α = 0.05,P 〈 0.05）. Results With Wilcoxon ranked data methods, u = 4. 478,P 〈 0.01, in the A group calculated with Kruskal-Wallis method, Hc = 2.179, P 〈 0.05, the difference indicated that the dilated ureter was superior to the normal side. The difference existed in the B groups had no statistic value Hc = 7. 441 ,P 〉 0.05. Conclusion Hypotonic diuretics drug can reduce the motion of the ureter, make the pelvis and ureter dilated, MSCT CPR with hypotonic diuretics is a safe, noninvasive and effective method.