MSCT在输尿管梗阻性病变中的应用价值

Application of Multi-slice Spiral CT in Diagnosis of Ureteric Obstruction

目的探讨多层螺旋CT(MSCT)技术对输尿管梗阻性病变的临床应用价值。方法对130例输尿管梗阻性病变患者均行MSCT肾脏、输尿管及膀胱扫描及输尿管重建。130例均经B超及静脉尿路造影(IVU)检查。输尿管重建方法有曲面重建、三维重建[包括最大密度投影(MIP)、表面遮盖成像(SSD)及VR容积重建]成像。结果 130例输尿管重建中,100例结石病变清楚显示其位置、大小、形态及输尿管梗阻扩张程度及范围,三维重建有助于了解管腔情况,显示输尿管腔内结石形态,能很好显示输尿管病变的部位、大小、形态以及范围,同时对病变波及周围组织、脏器也显示良好,对细小阳性结石更有价值。对泌尿系积水程度和肾实质厚度以及肾功能的判断,同样具有非常重要的参考价值,均优于传统的X线泌尿系检查。结论 MSCT输尿管重建可获得直观立体的输尿管成像;临床怀疑输尿管梗阻性病变时,螺旋CT输尿管三维重建,应作为一种常规检查方法,为临床治疗提供参考。

Objective To analyze the application of multi-slice spiral CT （ MSCT ） in diagnosis of ureteric obstruction. Methods All 130 patients who underwent ultrasound and intravenous urography, performed by MSCT and reconstruction, including curve planar reconstruction, maximum intensity projection, shaded surface display and volume render. Results Three dimensional construction located 100ureteral calculus with size, shape and the degree of ureteral obstruction. MSCT showed not only the information of calculus in ureteral, but also the pathological changes spread to surrounding tissue and organ, especially in tiny positive calculus. MSCT is better than traditional X-ray urology exam, especially at evaluation of the degree of obstruction, thickness of renal parenehyma and renal function. Conclusion MSCT of ureteral reconstruction can have direct viewing of ureter, and should be used routinely as clinical application in ureteral obstruction cases.