螺旋CT三维成像在上尿路梗阻诊断中的应用

The application of spiral computer tomography in the diagnosis of upper urinary obstruction

目的 评价螺旋CT三维成像技术 (3D -sCT)在上尿路梗阻中的应用价值。 方法 对113例上尿路梗阻行肾输尿管 3D -sCT检查 ,用遮盖表面显示法和最大密度投影法进行处理 ,获得立体三维图像 ,并与手术结果对照。 结果 全部病例三维立体形态显示良好 ,可显示病变的部位、形态 ,可从不同的角度和位置观察与周围结构的关系。 88例手术后诊断与 3D -sCT诊断结果完全相符 ,2 4例上尿路结石经 3D -sCT确诊后行体外冲击波碎石 (ESWL)治愈 ,1例腹膜后转移癌压迫输尿管经 3D -sCT确诊后保守治疗。诊断正确率 10 0 % (113/113)。 结论 3D -sCT可以准确反映上尿路梗阻的部位、病因、程度及与周围结构的关系 ,尤其适于IVU不显影及不能插管行逆行肾盂造影患者。

Objective To evaluate the diagnostic value of 3-dimentional spiral computer tomography (3 D- sCT) in patients with upper urinary tract obstruction. Methods 113 patients with upper urinary tract obstruction were subjected to 3D-sCT. Results The site of urinary tract obstruction and hydronephrosis were distinctly shown in all patients by 3D-sCT. 112 of them were confirmed by ESWL, pathological or operative findings. Conclusions 3D-sCT can exactly show the location, cause and interaction of the upper urinary obstruction, and is especially applied to patients with resultless IVP and unable to retrograde pyelography.