多层螺旋CT尿路成像对肾结核的诊断价值

MULTI-SLICESPIRAL CT UROGRAPHY DIAGNOSTIC VALUE OF RENAL TUBERCULOSIS

目的探讨肾结核的多层螺旋CT尿路成像（MSCTU）的影像表现，评价MSCTU对肾结核的诊断价值及临床应用。方法回顾性分析37例经临床尿培养、手术病理证实的肾结核的CT影像资料。本组病例男26例，女11例，年龄22～58岁。所有病例均行CT平扫和强化扫描，应用多平面重建、曲面重建及容积重建等技术，获得尿路成像图像。结果37例患者中，确诊前通过MSCTU诊断肾结核34例，准确率达91．9％；其中肾脏形态、大小改变28例，肾实质内多发大小不等囊状低密度灶28例，肾内出现钙化灶14例，累及输尿管7例，膀胱3例。结论MSCTU检查能够客观显示各期肾结核的病理特征，直观显示泌尿系全貌，逐渐取代了传统静脉肾孟造影（IVP）检查，对临床的诊断及治疗具有重要意义。

Objective To explore the imaging findings of multi - slieespiral CT urography （MSCTU） in renal tuber- eulosis and evaluate the diagnostic value of CTU for renal tuberculosis and clinical application. Methods Retrospective analysis of 37 patients by clinic and pathologically confirmed renal tuberculosis CT image data. This group of patients 26 males and 11 females, mean age was 32 （22 - 58） years. All patients underwent CT scan, get urography images through the applieation of multi - planar reconstruction, surface reconstruction and volume rendering techniques. Results Among the 37 cases,34 cases of patients diagnosed renal tuberculosis by CTU, the accuracy rate was 91.9%. Of them,kidney shape, size changed was seen in 28 cases. The low density area in renal parenchyma was seen in 28 cases. Tubercle calcification was seen in 14 cases. It had been involved 7 eases of ureter and 3 cases of bladder. Conclusion CTU may indicate objectively pathological feature of the renal tuberculosis in different phases and can be visually displayed of urology picture. It was replaced the traditional intravenous pyelography （IVP） gradually. It is important for clinical diagnosis and treatment.