基于不同扫描方案下MSCT尿路成像图像质量研究

Image Quality Analysis of MSCT Urography by Using Four Different Scan Protocols

目的探讨四种不同扫描方案下64层螺旋CT尿路成像技术的图像质量,寻求最佳的尿路显影方法。方法 60名泌尿系统正常人群分为4组,每组15名,分别采用以下辅助方法进行5分钟延迟扫描:A组,大量饮水仰卧位;B组,大量饮水俯卧位;C组,静脉水化;D组,少量利尿剂,对尿路连续性解剖结构、输尿管充盈度的显示进行图像质量对照评估。结果 A组和B组对于整个泌尿系统评价无明显差异,C组在尿路解剖结构的显示和尿路连续性评分方面与A、B组无明显差异,但是输尿管充盈程度明显高于A组(P=0.010)和B组(P=0.008)。D组的图像质量在尿路连续性评分和输尿管充盈度上明显高于其他3组,其平均输尿管内径显示最饱满,平均直径为(7.04±2.06)mm。结论少量利尿剂的使用能够显著增加泌尿系统全程显影,对泌尿系统的总体显示效果最好,值得临床推广应用。

Objective To evaluate the image quality of 64-slice helical computed tomography（ MSCT） urography by using four different scan protocols so as to find out the optimal urography protocol.Methods A total of 60 patients were randomly and equally divided into four groups with 15 cases in each group.Five-minute delayed scan with different supplementary methods were separately carried out in the patients of four groups： group A,drinking lots of water and taking supine position; group B,drinking lots of water and taking prone position; group C,intravenous hydration; and group D,using small amount of diuretics.The image qualities,including continuity of urinary system,the display of anatomical structures and the filling degree of the ureters,were evaluated,and the results were compared among the four groups.Results No statistically significant difference in the visualization of entire urinary system existed between group A and group B.No statistically significant difference in the visualization of urinary anatomical structures and the continuity of urinary system existed between group C and group A,as well as between group C and group B,although the filling degree of the ureters in group C was much better than that in group A（ P = 0.010） and group B（ P = 0.008）.The image quality,including the continuity of urinary system and the ureteral filling degree,of group D was obviously better than that of the other three groups.The mean ureteral diameter observed in group D was（ 7.04 ± 2.06） mm.Conclusion The use of small amount of diuretics can significantly improve the opacification of the whole urinary tract,thus the optimal visualization of the whole urinary system can be obtained.Therefore,this technique is worthy of clinical application.