多层螺旋CT尿路造影在医源性输尿管损伤诊断中的应用体会

Application of multislice spiral CT urography in diagnosis of iatrogenic ureteral injuries

目的探讨多层螺旋CT尿路造影(MSCTU)在医源性输尿管损伤的诊断价值。方法选取该院2009年3月至2012年3月收治的6例输尿管医源性损伤的病例,进行16排螺旋CT增强扫描,同时进行三维输尿管重建,将诊断结果与外科手术病理证实结果进行对照分析。结果 6例医源性输尿管损伤的病例进行MSCTU检查,均显影清晰,对比剂自受损的输尿管下段溢至宫颈阴道内,其中右侧输尿管2例,左侧输尿管4例;4例单处损伤,2例为多处损伤。损伤部位经外科手术病理证实均吻合,诊断符合率达到100%。结论 16排螺旋CT扫描速度快,图像后处理功能强大,图像分辨率高且质量好,可以清晰地观察到受损输尿管的部位及对比剂的流向,对医源性输尿管损伤定位、定性具有较高的临床应用价值。

Objective To explore the diagnostic value of multislice spiral CT urography（MSCTU） on iatro- genie ureteral injuries. Methods 6 cases of iatrogenic ureteral injury in our hospital from March 2009 to March 2012 were chosen and given 16-slice spiral CT and 3D ureteral reconstruction. The diagnostic results and the surgical pa- thology confirmed results were compared and analyzed. Results The MSCTU checks of 6 cases of iatrogenic ureteral injuries were all clearly developed. The contrast agent overflowed from the damaged inferior segment ureter to the cervix and vagina. In 6 cases.,2 cases were in right ureter and 4 cases were in left ureter,and 4 cases were single dam- age and 2 cases were multiple injuries. The sites of the injuries were confirmed by surgical pathology and the consist- ent diagnostic rate was 100~. Conclusion 16-slice spiral CT has quick scanning speed, powerful image processing function,high image resolution and good quality,which can be clearly observed the damaged ureter site and the current direction of contrast agent. It has higher clinical value on the positioning and qualitation of the iatrogenic ureteral injury.