输尿管下端先天性异常的MRI和MSCT诊断

Diagnosis of Congenital Anomaly of Lower Ureter with MRI and MSCT

目的:探讨MRI和/或MSCT对输尿管下端先天性异常的显示及临床价值。方法:回顾性分析16例经手术证实的输尿管下端先天性异常的MRI和/或MSCT检查,7例行MRI和MSCT者,只完成其中一种检查者9例(MRI5例,MSCT4例)。MRI的主要序列有轴面T1WI、轴面T2WI、矢状面或冠状面T2WI以及MRU;MSCT行平扫或增强扫描延迟期成像,扫描后薄建行后处理,主要采用多平面重组和曲面重组。结果:16例中双输尿管重复畸形4例,重复畸形合并异位开口7例,输尿管下端囊肿2例,输尿管下端囊肿合并多发结石1例,重复畸形合并输尿管下端囊肿2例,在MRI和/或MSCT上均得以显示。MRIT2WI序列对囊肿和积水的显示非常敏感,矢状面或冠状面对异位开口的显示较轴面清楚。MSCT的多平面重组(MPR)和曲面重组(CPR)可清楚显示输尿管的走行和异常。结论:MRI和/或MSCT可准确诊断输尿管下端先天性变异或畸形,应根据情况选择合适的扫描方法和序列。

Objective=To assess the value of MRI and MSCT in diagnosis of congenital anomaly of lower ureter. Methods： 16 surgically proved cases with congenital anomaly of lower ureter were examined with MRI and/or MSCT. 7 cases were examined with both MRI and MSCT, 9 cases with either MSCT or MRI （5 cases with MRI and 4 cases with MSCT）. Axial T1WI and T2WI, sagittal or coronal T2WI and MRU were performed. Routine MSCT and/or enhanced MSCT scan were carried out. The main post processing techniques were multiplanar reformation （MPR） and curved planar reformation （CPR）. Results： With MR and/or MSCT imaging, all 16 cases were diagnosed accurately,including duplication of the ureter in 4 cases,duplication of the ureter with ectopie orifice in 7 cases, ureterocele of lower part of the ureter in 2 cases, ureterocele of lower ureter with multiple calculi in 1 case,duplication of the ureter and ureterocele in 2 cases. On T2W images,hydroureter and ureterocele could be easily detected. On sagittal or coronal TzWI the location of eetopie ostium could be shown. On MPR or CPR images,whole course and anomaly of the ureter could be shown clearly. Conclusion= MRI and/or MSCT are valuable techniques to detect congenital anomaly of lower ureter. In clinical application, choosing a suit- able MRI sequence or MSCT post processing method according to the situation of a patient is essential.