磁共振尿路成像在上尿路梗阻性疾病诊断中的价值

Value of magnetic resonance urography in the diagnosis of upper urinary tract obstruction

目的探讨磁共振尿路成像(MRU)在上尿路梗阻性疾病诊断中的价值。方法总结分析46例上尿路梗阻患者的临床资料,比较分析MRU、多排螺旋CT(MDCT)、静脉尿路造影(IVU)、B超的诊断准确率。结果 MRU对尿路肿瘤性病变、炎性病变、结核、泌尿系畸形的诊断准确率分别为90.0%、100.0%、100.0%、100.0%,优于IVU(37.5%、50.0%、50.0%、75.0%)和B超(40.0%、50.0%、50.0%、25.0%),差异均有统计学意义(均P<0.05);MRU与MDCT对肿瘤性病变及结核的诊断准确率比较,差异无统计学意义(P>0.05);MRU与MDCT对炎性病变、泌尿系畸形的诊断准确率比较,差异有统计学意义(P<0.05);MRU、MDCT、IVU、B超对结石的诊断准确率分别为81.8%、95.5%、90.9%、72.7%,差异无统计学意义(P>0.05)。结论 MRU对上尿路梗阻的定位、定性诊断准确率高,能够更加清晰地显示上尿路梗阻的病变及形态,在上尿路梗阻诊断方面有独特的优势。

Objective To evaluate the use of magnetic resonance urography （MRU） in the diagnosis of upper urinary tract obstruction. Methods Clinic data of 46 patients suffered from upper urinary tract obstruction were analyzed, and the diagnosis accuracy of MRU, muhidetector CT （MDCT）, intravenous urography （IVU）, and ultrasound were compared and analyzed. Results The diagnosis accuracy of urinary tract tumor lesions and inflammatory disease, tuberculosis, uri- nary tract malformation by MRU （90.0%, 100.0%, 100.0%, 100.0%） were superior to those of IVU （37.5%, 50.0%, 50.0%, 75.0%） and ultrasound （40.0%, 50.0%, 50.0%, 25.0%）, the differences were statistically significant （all P 〈 0.05）. The difference of diagnosis accuracy rate between MRU and MDCT on tumor lesions and tuberculosis were no statistically significances （P 〉 0.05）; the differences of diagnosis accuracy rate between MRU and MDCT on inflamma- tory disease and urinary tract malformation were statistically significant （P 〈 0.05）. The diagnosis accuracy of lithiasis by MRU, MDCT, IVU, ultrasound were 81.8%, 95.5%, 90.9% and 72.7% respectively, which had no statistically signif- icanees （P 〉 0.05）. Conclusion For upper tract obstruction positioning, the accuracy rate of qualitative diagnosis and orientation by the using of MRU is high. MRU can more clearly show the pathological changes and form of urinary tract obstruction, which has a unique advantage in diagnosis of the upper tract obstruction.