MRU在泌尿系梗阻性疾病中的临床应用价值

Evaluation of Clinical Application of MR Urography in Diagnosis of Urinary Tract Obstruction

目的 :评价磁共振尿路造影(MRU)对泌尿系梗阻性疾病的临床应用价值。材料和方法 :采用快速自旋回波(FSE)重T2 加权序列对70例患者进行泌尿系冠状位扫描 ,将图像按最大强度投影(MIP)法重建出MRU图像。经手术和病理证实为尿路梗阻者24例 ,其中尿路结石12例 ,尿路先天性梗阻4例 ,输尿管炎性狭窄3例 ,炎性息肉2例(其中1例为炎性息肉伴输尿管结石) ,其他4例。结果 :各例的MRU均清晰显示梗阻的尿路 ,对肾盂积水及尿路梗阻部位显示良好 ,解剖结构清晰。结合MR与其他影像资料 ,可对梗阻作出定性诊断。结论 :MRU是无创伤的检查方法 ,不接触射线 ,不需碘对比剂 ,诊断尿路梗阻性疾病定位、定性准确 ,是一种新的安全的影像检查手段 ,尤其适用于因严重梗阻IVP显影不良的病例。

Purpose: To evaluate the clinical application of MR urography(MRU)in the diagnosis of urinary tract obstruction. Materials and Methods: 70 patients were examined with fast spin-echo heavily T2 weighted sequence,acquired in coronal plane.After elimilation of the unrelated parts on the images slice by slice the three dimentional raw data of the urinary tract were project into a composite image of MRU using a maximum intensity projection (MIP) algorithm. 24 patients were verified by operation and pathology, including ureteral calculus(n=12), congenital ureteral stricture(n=4), stricture caused by chronic inflammation(n=3), polyp(n=2)and others(n=4). In one patient, both polyp and stone were found. Results: MRU provided high resolution images of urinary tract in all patients with urinary tract obstruction, The locations of urinary tract in all patients and the causes of hydronephrosis were distinctly showed. Conclusion: MRU is a noninvasive technique with excellent accuracy in the diagnosis of urinary tract obstruction. It does not require iodinated contrast material and has no ionizing radiation. MRU is a new and safe imaging technique for urinary tract obstruction. It is especially useful for patients with severe hydronephrosis whose IVP can not display the urinary tract well.