CT三维成像在经皮肾镜取石手术中的临床应用

Clinical Application of Three Dimensional CT Reconstruction in Percutaneous Nephrolithotomy

目的:评价CT三维成像技术在经皮肾镜取石手术中的应用价值。方法:对34例肾脏多发结石、鹿角状结石患者行KUB、IVU和CT检查,并应用CT三维成像处理技术对CT图像进行处理。所有患者均行手术治疗。结果:34例患者经皮肾穿刺取石,结石清除率达96.8%,无术中术后大出血发生。结论:在经皮肾镜取石手术中,CT三维成像处理获得的三维图像较KUB、IVU和普通CT图像对复杂性肾结石的定位与穿刺更具优越性,简便易行,安全性高。CT三维成像处理技术可提供肾盂肾盏集合系统的清晰图像,并可准确发现结石,判断结石的立体形状及其与肾盂肾盏的关系,有利于明确经皮肾穿刺部位。

Objective： To evaluate the clinical value of three dimensional CT reconstruction for preoperative planning of pereutaneous nephrolithotomy in patients with renal calculi. Methods： 34 patients with renal calculus underwent M SCT scanning by a hi-speed advantage scanner （Philips TOMOSCAN -EG）. Three -dimensional models of the patient＇s kidney and calculus were generated based on CT image data by correlative software. Results： All patients had pereutaneous nephrolithotomy （PCNL） ,the stone -free rate was 96.8% ,no severe hemorrhage was recorded. Conclusions： CT could set up three-dim ensional of kidney and calculus. According to these image, urologist could understand the three-dimensional structure of the kidney and calculus before operation, and may perform operation more easily and safely. 3DCT provided a good map of the pelvicalyceal system （PCS） and renal vascular. With reconstructed images, subjectively the 3D imaging provided an advantage over conventional imaging in optimizing nephrostomy plscement.