多层螺旋CT非增强扫描及三维成像对输尿管结石梗阻的诊断

Application Value of Non-enhanced Multislice CT Scan Combined with 3D Imaging in Diagnosis of Obstruction of Ureteral Calculi

目的探讨多层螺旋CT非增强扫描结合三维成像对输尿管结石梗阻的诊断价值.方法收集经手术及临床治疗证实的120例输尿管结石梗阻病例的临床及影像学资料.所有病例均行螺旋CT非增强扫描后,数据传输至后处理工作站行任意方向、多角度、适当层厚MPR(多平面图像重组),个别病例依诊断及临床需要,进行SSD(表面遮盖显示)、VRT(容积重建技术)、CPR(曲面重组)等后处理三维成像.结果 120例中肾盂输尿管结合部结石16例,其中单侧多发2例;输尿管腹腔段、盆腔段、壁内段结石104例,其中输尿管腹腔段结石45例,输尿管盆腔段35例,输尿管壁内段24例,单侧多发9例,双侧多发5例.本组病例病变部位、大小、形态、数目、继发输尿管扩张积水情况通过三维成像均可直观显示.结论多排螺旋CT非增强扫描结合三维成像对泌尿系输尿管结石梗阻定位、定性诊断具有较高的临床应用价值,对临床治疗方案的选择具有指导意义.

Objective To explore the value of non-enhanced multislice CT scan combined with 3 d imaging in diagnosis of obstruction of ureteral calculi.Methods We collected the clinical and radiographic data of 120 patients with reteral calculi obstruction confirmed by operation in our hospital.All patients were given non-enhanced multislice CT scan,and the data were transmitted to post-processing workstation to do any direction,multiple perspectives,thick layer of appropriate MPR（more graphic image restructuring）.For the diagnostic and clinical needs of individual cases,the data was transformed to 3-d imaging after post-processing with SSD（surface cover shown）,VRT（volume reconstruction technique）and CPR（surface restructuring）.Results In 120 patients,there were 16 cases of renal pelvis ureteral stone,45 cases of ureteral stone in abdominal segment,35 cases of ureteral stone in pelvic segment,and 24 cases of ureteral stone in inner wall,9 cases of ureteral obstruction of multiple stones and 5 cases of bilateral ureteral calculi.Forall the cases,pathological changes of size,shape,number,secondary ureteral expansion water situation could be displayed through 3 d imaging.Conclusion Non-enhanced multislice CT scan combined with 3 d imaging has higher clinical value in qualitative diagnosis of urinary tract obstruction site of ureteral calculi,and has guiding significance for clinical treatment options.