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目的 探讨螺旋CT及其泌尿系成像 (spiralCTurography ,SCTU)技术对输尿管病变的诊断价值。方法 2 7例输尿管病变患者中 ,结石 9例、肿瘤 5例、狭窄 9例、畸形 1例、炎症 1例及输尿管瘘 2例。均行螺旋CT泌尿系检查。注射对比剂后 10~ 15min行螺旋CT容积扫描 ,在工作站利用软件进行图像后处理 ,获得泌尿系立体图像。其中 15例同时行螺旋CT平扫 ,10例行静脉泌尿系造影。结果 (1)螺旋CT平扫 8例阴性结石清晰可见。 (2 )SCTU图像上 ,8例阴性和 1例阳性结石可见其位置、形态、大小及扩张的肾盂和输尿管 ;5例输尿管肿瘤可见局部管腔内对比剂柱变细或突然中断 ,管壁不光整 ;7例单纯狭窄可见狭窄部位管腔逐渐变细 ,管壁无明显增厚。 2例迷走血管压迫致狭窄者均位于肾盂输尿管交界处 ;1例重复肾并输尿管畸形者显示双肾盂、双输尿管 ;输尿管瘘者显示瘘口位置、走行。结论 与普通CT及静脉泌尿系造影 (IVU)相比 ,螺旋CT及其SCTU技术有明显优越性 ,可使输尿管病变诊断准确率明显提高
Objective To investigate the diagnostic value of spiral CT and spiral CTurography (SCTU) in the diagnosis of ureteral diseases. Methods Twenty-seven patients with ureteral lesions included 9 stones, 5 tumors, 9 stenosis, 1 deformity, 1 inflammation and 2 ureteral fistulas. All patients underwent spiral CT urinalysis. After injection of contrast agent 10 ~ 15min spiral CT volume scan, using software at the workstation post-processing, to obtain three-dimensional images of the urinary tract. Among them, 15 cases underwent simultaneous spiral CT scan and 10 cases received intravenous urography. Results (1) Spiral CT plain 8 cases of negative stones clearly visible. (2) On the SCTU images, the location, shape, size and dilated renal pelvis and ureter were visible in 8 cases of negative and 1 case of positive stones. In 5 cases of ureteral tumors, the contrast medium column in local lumen narrowed or abruptly disrupted. Whole; 7 cases of narrow stenosis visible lumen narrowing, no significant thickening of the wall. 2 cases of vagotomy caused by stenosis were located in the junction of the ureteropelvic; 1 case of repeated renal and ureteral malformations showed double renal pelvis, double ureter; ureteral fistula showed fistula position, walk. Conclusion Compared with common CT and intravenous urography (IVU), spiral CT and its SCTU technology have obvious advantages, which can significantly improve the diagnostic accuracy of ureteral lesions