多层螺旋CT尿路成像技术对输尿管疾病诊断价值的研究

CLINICAL EVALUATION OF MULTI-SLICE SPIRAL CT UROGRAPHY IN THE DIAGNOSIS OF URETERAL DISEASES

目的:探讨多层螺旋CT尿路成像技术(MSCTU)对输尿管疾病的诊断价值。方法:收集37例输尿管疾病病人行MSCTU检查。所有病例均行平扫、动脉期、静脉期、延时期四期扫描,对所获容积数据进行三维重建处理,主要的重建方法有:最大密度投影、多平面重建、容积再现和曲面重建。然后分析轴位像与CTU三维图像表现,比较两种观察手段的定位诊断符合率及定性诊断符合率,并与手术病理或临床资料对照。结果:CTU单纯轴位像与轴位像结合CTU对各种输尿管疾病的定位诊断符合率分别为75.7%和97.3%(χ2=7.4,P<0.05),定性诊断符合率分别为73.0%和94.6%(χ2=6.366,P<0.05)。结论:MSCTU可得到比单纯轴位像更多的诊断信息,并对输尿管病变作出较准确的定位、定性诊断,能够为临床工作者提供较丰富而全面的诊断信息,更有助于疾病的诊断、治疗及预后。

Objective： To evaluate the diagnostic value of Multi- slice Spiral CT Urogrophy （MSCTU） in ureteral diseases. Method：37 cases with ureteral diseases who had undergone MSCTU have been collected. All patients were performed four-phase scanning including plain CT scan, arterial phase scan, venous phase scan and delayed phase scan. The volume data of all patients were reconstructed with 3D reconstruction techniques including maximum intensity projection（MIP） , volume rendering （ VR ） , multi - planar reformation （ MPR ） and curved planar reformatting （CPR）. Transverse images and three-dimensional images of CTU in these 37 cases were studied retrospectively for the accuracy of location and nature of the lesion, and the findings were compared with the surgical and pathological results or with clinical data. Results：The accuracy of location for transverse images and three-dimensional images of CTU combined with transverse CT scans in diagnosis of ureteral diseases were 75.7% and 97.3% （ X2 = 7.4, P 〈 0.05 ）. The accuracy for transverse images and three - dimensional images of CTU combined with transverse CT scans in diagnosis of ureteral diseases were 73.0% and 94.6% （ X2 = 6. 366, P〈0.05 ）. Conclusion： Combined with transverse CT scans, MSCTU can provide more information in making accurate diagnosis for the location, nature of the lesion and is more helpful to diagnosis ,treatment and prognosis in ureteral diseases.