MSCTU在泌尿系梗阻性疾病中的应用

Evaluation of multislice computed tomography urography in diagnosis of urologic obstruction

目的 :评价多层螺旋CT尿路三维成像在泌尿系梗阻性疾病中的诊断价值。方法 :对102例临床初步诊断为梗阻性泌尿系疾病并作MSCTU成像的患者进行回顾性分析。对泌尿系的MSCTU显示率,梗阻部位和原因,梗阻程度与病变部位及性质相互关系进行评价。结果:102例患者共计110处病变,泌尿系CTU显示106处,显示率为96.36%。泌尿系腔内病变引起尿路0、Ⅰ、Ⅱ、Ⅲ度梗阻分别为15、33、25、17处;腔外病变引起0、Ⅰ、Ⅱ、Ⅲ度梗阻分别为15、4、1、0处,泌尿系腔内病变引起尿路梗阻较腔外病变严重,两者在梗阻程度上差异有统计学意义(P<0.001);泌尿系良性病变中0、Ⅰ、Ⅱ、Ⅲ度梗阻分别为20、31、25、16处,恶性病变中0、Ⅰ、Ⅱ、Ⅲ度梗阻分别为10、6、1、1处,恶性病变致尿路梗阻程度轻于良性病变,两者比较有差异有统计学意义(P<0.05)。结论:128层螺旋CT尿路三维成像能清晰显示泌尿系梗阻部位、原因、程度,以及尿路与邻近组织或病变的关系,对梗阻病变的定性有较高的准确率,并能提示肾脏排泄功能有无受影响。创伤性小、检查便捷、梗阻检出阳性率高,可作为泌尿系梗阻性疾病诊断的重要检查方法。

Objective：To evaluate the 128-slice spiral CT with 3-dimensional reconstruction in the diagnosis of uro-logic obstruction. Methods：102 cases of patient primarily diagnosed as urinary obstructive disease in clinic underwent the multislice CT urography scan. The images were reconstructed by 3-dimensional post-process techniques retrospectively to explore the obstructive causes, levels, degrees, and to evaluate the relationships. Results： There were 110 cases of affected urinary tracts in the 102 patients, and 106 cases （96.36%） were shown by MSCTU. Different degrees （no, mild, moderate and severe） of obstructions were exhibited in 15,33,25 and 17 cases with lesions inside of the urinary tract, and 15,4,1 and 0 cases with lesions outside of the urinary tract, respectively. There was significant difference in obstructions between le-sions inside and outside the urinary tract （P〈0.001）. Different degrees （no, mild, moderate and severe） of obstructions were presented in 20,31,25 and 16 cases with benign lesions, and 10,6,1 and 1 cases with malignant lesions, respectively. The difference was also significant in obstructions between benign and malignant lesions （P〈0.05）. Conclusion： The 128-slice spiral CT with 3-dimensinal reconstruction can reveal the locations and degrees of obstruction, and the relationship with the peripheral tissue or lesions. The method can identify the obstructive causes conveniently. It is also a hint of the excreto-ry function of kidney. It can be considered as the preferred method to check the obstruction of the urinary system in the light of its minor wound, and the easiest operation with higher positive rates.