多排螺旋CT同步肾动脉和肾盂输尿管显影在腔镜手术中的临床价值

Clinical value of multiple-slice spiral CT synchronous imaging of renal arteries,renal pelves and ureters in endoscopic surgeries

目的探讨多排螺旋CT同步肾动脉和肾盂输尿管显影在腔镜手术中的临床价值。方法分析12例术前CT分次注射造影剂同步肾血管和肾盂输尿管显影的影像资料,评估其对腔镜手术的临床价值。结果 12例中因2例肾重度积水行输尿管肾盂逆行造影与肾动脉同步显影外,10例肾盂输尿管与肾动脉同步显影良好。肾盂输尿管全程显影8例,2例肾盂肾盏显影。显示4级以上肾动脉11例,显示3级肾动脉1例。所有病例行腔镜手术并证实术前诊断。结论同步肾动脉和肾盂输尿管显影技术可了解术前肾盂输尿管及其血管的解剖信息,为泌尿系疾病病因学的诊断、术前术式的选择提供参考,以减少腔镜手术的风险提供重要影像学资料。

Objective To investigate the clinical value of endoscopic surgeries in multiple-slice spi- ral CT synchronous imaging of renal arteries and the renal pelves and ureters. Methods Prospectively re- searching, 12 patients＇ contrast media was injected preoperatively to achieve synchronous imaging of renal vessels and the renal pelves and ureters were evaluated. Results For 2 of the 12 patients retrograde ra- diography of the renal pelves and ureters were carried out to achieve synchronous imaging with the renal arteries, while 10 cases had good synchronous imaging of renal vessels and the renal pelves and ureters. The whole range of pelves and ureters showed in 8 cases. The pelves and calices showed in 2 cases. Over 4-branch ateries showed in 11 of the i2 cases, while 3-branch renal ateries showed in the balance 1 case. In all of the 12 cases, endoscopic surgeries were performed without complications and the preoperative diagnoses were approved. Both the preoperative and postoperative tests of renal function indicated no statistic difference. Conclusions Synchronous imaging of renal vessels, renal pelves and ureters as well as 3-dimensional reconstruction made it possible to know the anatomical informaiton of renal pelves, ureters, renal vessels and the spatial relation between them, which provided not only important references for etiological diagnoses and preoperative section of surgical approaches in urologic diseases but also significant imageolo- gy data for reducing risks of laparoscopic and endoincision operations.