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目的探讨多层螺旋CT尿路成像(MSCTU)在诊断泌尿系先天异常方面的特点、成像方法及其临床应用价值。方法搜集3年间临床资料完整的泌尿系先天异常患者33例,均行MSCTU成像,对全泌尿系扫描,排泄期图像进行最大强度投影(MIP)、多平面重组(MPR)、容积重组(VR)、仿真膀胱镜(VC)检查,获得完整、立体的尿路影像。结果经MSCTU诊断泌尿系先天异常33例,包括异位肾、马蹄肾、肾盂旋转不良各1例,附加肾、输尿管瓣膜症、腔静脉后输尿管各2例,巨输尿管4例,肾盂输尿管交界处狭窄6例,双肾盂双输尿管9例,膀胱憩室5例。输尿管显示率91% (61/66侧),所有显影输尿管中上段腔内对比剂平均CT值520 HU,后处理图像显示泌尿系解剖结构清晰、立体感强,完全能满足诊断。结论MSCTU对显示泌尿系先天异常的整体解剖形态和细微病理变化能力强,能明显提高诊断率,可作为首选检查方法。
Objective To investigate the characteristics, imaging methods and clinical value of MSCTU in the diagnosis of urinary tract congenital anomalies. Methods Thirty-three patients with congenital anomalies of urinary tract were enrolled in this study. All patients underwent MSCTU imaging with maximum intensity projection (MIP), multiplanar reconstruction (MPR), volumetric reorganization (VR) , Simulation cystoscopy (VC) examination, to obtain a complete, three-dimensional urinary tract imaging. Results The diagnosis of urinary tract congenital anomalies by MSCTU in 33 cases, including ectopic kidney, horseshoe kidney, poor renal pelvis in 1 case, additional kidney, ureteral valvular disease, 2 cases of posterior vena cava ureter, 4 cases of giant ureter, ureteropelvic junction Stenosis in 6 cases, double renal pelvis double ureter in 9 cases, bladder diverticulum in 5 cases. The ureter display rate was 91% (61/66 side). The average CT value of the contrast medium in the upper part of the developing ureter was 520 HU. The post-processing image showed that the urinary system had clear anatomy and stereoscopic feeling, which fully met the diagnosis. Conclusion The MSCTU has strong ability of displaying the anatomical anatomy and minor pathological changes of urinary congenital anomalies and can significantly improve the diagnostic rate, which can be used as the preferred method of examination.