64层螺旋CT尿路成像与静脉尿路造影对照分析

The comparative study between the 64-slice spiral computed tomography urography and intravenous urography

目的探讨64层螺旋CT尿路成像(CTU)与静脉尿路造影(IVU)对泌尿系病变的应用价值。方法 130例临床疑诊泌尿系病变的患者,先进行IVU,再行64层螺旋CT尿路成像检查,通过工作站进行多种后处理,比较两者结果。结果 IVU诊断正常3例,诊断泌尿系结石95例,其中肾结石50例,输尿管结石44例,膀胱结石1例,输尿管外压病变2例,泌尿系畸形6例,肿瘤7例,感染性病变1例。CTU诊断正常2例,诊断泌尿系结石106例,其中肾结石60例,输尿管结石45例,膀胱结石1例,外压病变4例,泌尿系畸形9例,肿瘤20例,感染性病变17例。对于泌尿系结石、畸形的诊断两种方法无统计学差异(P>0.05),对于泌尿系肿瘤、感染的诊断两者有统计学差异(P<0.05)。结论 64层螺旋CT通过多种后处理方法,既可全景显示泌尿系的形态结构,也可观察局部病变细节,对泌尿系各种疾病的诊断有重要的临床价值;而对于泌尿系单纯结石性梗阻亦可采用IVU。

Objective To evaluate of the clinical application of the 64-slice spiral computed tomography urography （CTU） and intravenous urography （IVU）. Methods The intravenous urography and 64-slice spiral computed tomography urography of 130 patients with clinically suspected urinary system disease were comparative ustudied. Raw CT data were reconstructed by reconstruction processing work station. Results In IVU, 3 patients were normal and in CTU, 2 patients were normal. Urolithiasis were found in 95 patients by IVU, kidney stones in 50 cases, ureteral calculus in 44 eases, vesi- cal calculus in 1 case, 2 cases ureteral outside pressed, malformation in 6 cases, tumour in 7 cases, infective in 1 case. Urolithiasis were found in 106 patients by CTU, kidney stones in 60 cases, ureteral calculus in 45 cases, vesical calculus in 1 case, in 4 cases ureteral outside pressed, malformation in 9 cases, tumour in 20 cases, infection in 17 cases. It had not statistical difference between the two methods to urinary calculi, deformity （ P 〉0.05）, but for infection, tumor had sta- tistical difference （ P 〈0.05）. Conclusion 64-slice spiral computed tomography urography through a variety of post-pro- cessing method can show the panoramic urinary morphological structure, also, can observe local lesion details, play an im- portant role in clinical diagnosis; And IVU can be used for urinary obstruction by simple stone.