轴位MRI图像在磁共振尿路成像中的诊断价值

MR Axial Image and MR Urography in the Evaluation of the Obstructive Diseases of the Urinary System

目的 比较磁共振轴位图像和水成像对尿路梗阻性病变的诊断作用和价值。方法 选择经手术病理证实的尿路梗阻性病变 2 0例 ,其中男 15例 ,女 5例 ,年龄 2 9～ 86岁。所有病例均使用GE1.5T超导型磁共振成像仪检查 ,采用SSFSE序列和FRFSE序列重T2WI技术作磁共振尿路成像及轴位磁共振成像等检查。结果 ① 2 0例病人中有输尿管癌 4例 (双侧 1例 ) ,膀胱癌 5例 ,肾盂癌 2例 ,肾、输尿管结石 6例 ,其他 3例。②MRU检查 2 0例显示梗阻部位 19例 ,提示占位征象 4例 ,梗阻端占位性病因诊断率为 16 .7%。而轴位MRI图像显示占位性改变 16例次 ,并同时显示管壁异常 ,占位性梗阻的病因诊断率为 6 6 .7%。结论 MRU可以直观地显示尿路的梗阻部位和程度 ,但对梗阻端的结构显示欠佳 ;而轴位MRI图像则能清楚地显示梗阻端的内部结构和外围关系 ,弥补了MRU的不足 ,因此轴位MRI图像在MRU对尿路梗阻性疾病的诊断中有不可缺少的作用。

Objective To evaluate the MR axial image and MR urography (MRU) in the diagnosis of the obstructive diseases of the urinary system. Methods Twenty patients were consecutively recruited in the study, who were proved by surgery of urinary system obstructive diseases. There were 15 males and 5 females in the group, aged from 29 to 86. All the patients were examined by GE 1.5T MR scanner. MRU images were obtained by using SSFSE and FRFSE T2 weighted sequences. MR axial images were obtained by using the same sequences with different parameters. Results ①The final diagnosis was: 4 ureter cancers (1 bilateral), 5 bladder cancers, 2 calyx caners, 6 renal and ureter calculus and 3 other diseases. ②In MRU images, 19 cases displayed obstruction, 4 of them suggested mass lesion, therefore the detection rate of the space occupying lesion was 16.7%. In MR axial images, 16 cases displayed space occupying lesion and the abnormal uretal wall, therefore the detection rate of the space occupying leson was 66.7%. Conclusion MRU can directly reveal the location and extent of the obstruction of the urinary system, but hard to display the surrounding structures of the lesion. MR axial images can delineate the lesions and easy to evaluate the relationship of the lesion to the neighbour structures. It may give additional information to the MRU, and should be carry on after the MRU examination.