磁共振尿路造影在尿路梗阻性病变中的应用

The Application of Magnetic Resonance Urography in Urinary Tract Obstructive Lesions

目的:探讨磁共振尿路造影(MRU)在尿路梗阻性疾病中的应用及特点与评估尿路梗阻病变的价值。方法:收集经过碎石或病例证实的尿路梗阻病变患者57例,采用Philips Achieva 1.5T双梯度超导磁共振成像仪,仰卧头先进,Sense-Body线圈,先行轴位和冠状位FSE序列呼吸门控T2WI成像及SE序列呼吸门控T1WI成像,MRU采用快速自旋回波序列作冠状面重T2加权水成像,并在工作站上进行三维最大密度投影重建,得出尿路造影图像,再进行手术或病例对照研究。结果:57例行MRU检查的患者,发现泌尿系狭窄20例,泌尿系结石22例,原发性泌尿系肿瘤5例,泌尿系畸形4例,原发性巨泌尿系3例,异位血管压迫泌尿系3例。MRU对尿路梗阻部位的定位诊断准确率100%,定性诊断准确率87.7%。结论:MRU对尿路梗阻性病变的定位和定性诊断准确率高,但需综合临床表现及进一步积累经验。

Objective： To study the application of magnetic resonance urography （MRU） in urinary tract obstruction, and it＇s characteristics and value of assessment on urinary tract obstruction. Methods： 57 patients with urinary tract obstruction lesions confirmed by gravel or cases were collected, by using Philips Achieva 1.5 T superconducting double gradient magnetic resonance scanner, supine head first, Sense-Body coil, first axial and coronal T2WI FSE sequences with respiratory gating and SE T1WI sequence with respiratory gating were underwent on them, MRU through using fast spin echo sequences of T2-weighted coronal re-water imaging, and three-dimensional maximum intensity projection reconstruction on workstation, the urography images were obtained ,and contrast to surgery or case study. Results： 57 pantients with MRU examinations were undewent, found 20 urinary stricture, 22 urinary calculi, 5 primary tumors of urinary system, 4 urinary tract abnormalities, 3 primary giant urinary tract, 3 urinary ectopic vascular compression department, the location diagnosis accuracy of MRU in urinary tract obstruction was 100%, qualitative diagnostic accuracy was 87.7%. Conclusion： The location and qualitative diagnostic accuracy of MRU in urinary tract obstruction was high, to the further, combined the clinical and comprehensive experience.