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目的探讨128层螺旋CT尿路造影(128-slice spiral CTU)在上尿路梗阻性疾病诊断中的价值。方法搜集经B超或静脉肾盂造影(IVU)检查提示上尿路梗阻而原因不明的患者30例,均行128层螺旋CT尿路造影检查,在工作站对获得的图像进行多平面重建(MPR)、容积再现(VRT)及最大密度投影(MIP)等三维后处理,获得泌尿系立体图像。结果 30例中上尿路结石15例,先天性畸形7例,肾盂输尿管癌2例,输尿管炎性狭窄3例,邻近器官病变导致的上尿路梗阻1例,以上病例均经手术或输尿管镜检证实,2例未确诊,诊断准确率为93.33%。结论 128-slice spiral CTU通过MPR、VRT、MIP、CPR技术多角度观察能够更加清晰地显示出导致上尿路梗阻的病变及其形态,在上尿路梗阻病变诊断方面有独特的优势。
Objective To investigate the value of 128-slice spiral CTU in the diagnosis of upper urinary tract obstruction. Methods Thirty patients with unclear causes of upper urinary tract obstruction who were examined by B-mode ultrasonography or intravenous pyelography (IVU) were examined by 128-slice spiral CT urography. Multi-plane reconstruction (MPR) images were obtained from the workstation. , Volume Reproduction (VRT) and Maximum Density Projection (MIP) to obtain three-dimensional urography images. Results Thirteen cases of upper urinary tract calculi in 15 cases, 7 cases of congenital malformation, 2 cases of ureteropelvic cancer, ureteral inflammatory stenosis in 3 cases, adjacent organ lesions caused by upper urinary tract obstruction in 1 case, the above cases were surgery or ureteroscopy Check confirmed, 2 cases were not diagnosed, the diagnostic accuracy was 93.33%. Conclusion The multi-angle observation of 128-slice spiral CTU with MPR, VRT, MIP and CPR techniques can clearly show the pathological changes of the upper urinary tract obstruction and its morphology. It has unique advantages in the diagnosis of upper urinary tract obstruction.