李亭 1,2 , 郭春梅 1,2 , 王成龍 1 , 李真林 1 , 張洪靜 1 , 伍兵 1
  • 1 四川大學(xué)華西醫(yī)院放射科（成都，610041）; 2 綿陽(yáng)市人民醫(yī)院放射科;

【摘要】　目的　 探討64層螺旋CT尿路造影在上尿路梗阻性病變中的運(yùn)用及診斷價(jià)值。　方法　 收集2009年12月—2011年1月132例行螺旋CT尿路造影，并確診為上尿路梗阻病變患者資料，分析其圖像特點(diǎn)并與手術(shù)及病理結(jié)果對(duì)比。　結(jié)果　 132例患者經(jīng)臨床及手術(shù)病理證實(shí)，輸尿管結(jié)石31例，先天異常及畸形51例，輸尿管感染性病變16例，尿路腫瘤29例，外源性壓迫3例，腎盂旁囊腫2例；所有患者均顯示良好，與臨床及病理結(jié)果基本吻合。　結(jié)論　 CT尿路造影能多方位清楚顯示病變內(nèi)部及周圍情況，可準(zhǔn)確的顯示、判斷尿路梗阻的原因、性質(zhì)，是一種對(duì)泌尿系疾病診斷極有價(jià)值的影像學(xué)檢查方法。
【Abstract】　Objective　 To discuss the utilization and diagnostic value of 64-slice spiral CT urography for upper urinary tract obstruction diseases. 　Methods　 We collected the clinical data of 132 patients who were diagnosed with upper urinary tract obstruction by 64-slice spiral CT urography between December 2009 and January 2011. We analyzed the imaging features and compared them with surgical and pathological results. 　Results　 Confirmed by surgical and pathological results, 132 patients included 31 cases of urethral stone, 51 cases of congenital variant and malformation, 16 cases of ureteral infection, 29 cases of tumors in urinary tract, 3 cases of extraneous compression, and 2 cases of cysts next to the renal pelvis. CT diagnosis for all cases were basically in line with clinical and pathological results. 　Conclusion　 CT urography is an extremely valuable imaging method to diagnose the diseases of urinary system. It can display lesions broadly and reveal their inner and peripheral circumstances clearly, thus can help us determine the reasons and natures of the lesions precisely.

引用本文： 李亭,郭春梅,王成龍,李真林,張洪靜,伍兵. 螺旋CT尿路成像在上尿路梗阻性病變的運(yùn)用及診斷價(jià)值. 華西醫(yī)學(xué), 2011, 26(5): 702-706. doi: 復(fù)制

1. 　陶然, 趙躍華, 劉金, 等. 螺旋CT多層面和多維重建在泌尿系疾病診斷中的應(yīng)用[J]. 中華泌尿外科雜志, 2007, 28(6): 382-338.
2. 　Caoili EM, Cohan RH, Korovkin M, et al. Urinary tract abnormalities: initial experience with multidetector row CT urography[J]. Radiology, 2002, 222(2): 353-360.
3. 　舒紅格, 漆劍平, 黃文華, 等. MSCT尿路成像診斷泌尿系統(tǒng)疾病: 與IVP檢查的對(duì)比研究[J]. 放射學(xué)實(shí)踐, 2006, 21(5): 468-470.
4. 　黃忠雄, 何玉成, 胡六才, 等. 16 層螺旋CT尿路三維重建在泌尿系梗阻性疾病診斷中的價(jià)值[J]. 放射學(xué)實(shí)踐, 2008, 26(1): 59-61.
5. 　Rimondini A, Morra A, Bertolotto M, et al. Spiral CT with multiplanar reconst ructions (MPRS) in the evaluation of ureteral neoplasms: preliminary results[J]. Radiol Med, 2001, 101(6): 459-465.
6. 　張瑜, 李霄麟, 于紅, 等. 多層CT尿路造影: 一種改良尿路顯影法的初步應(yīng)用[J]. 中國(guó)計(jì)算機(jī)成像雜志, 2009, 15(4): 385-388.
7. 　李澄, 王禮同, 湯曉明, 等. 多層螺旋CT曲面重建尿路成像技術(shù)的應(yīng)用[J]. 放射學(xué)實(shí)踐, 2004, 19(9): 644-646.
8. 　徐怡, 王小寧, 唐立鈞, 等. MSCTU對(duì)泌尿系統(tǒng)先天性疾病的診斷價(jià)值[J]. 中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志, 2006, 12(1): 40-43.
9. 　徐學(xué)勤, 董海鵬, 陳克敏, 等. 尿路病變CT尿路造影的臨床應(yīng)用[J]. 中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志, 2008, 14(3): 213-216.
10. 　李松年. 中華影像醫(yī)學(xué)泌尿生殖系統(tǒng)卷[M]. 北京: 人民衛(wèi)生出版社, 2002: 78.
11. 　王萬(wàn)勤, 劉斌, 余永強(qiáng), CT尿路成像技術(shù)現(xiàn)狀[J]. 國(guó)際醫(yī)學(xué)放射學(xué)雜志, 2009, 32(51): 467-470.
12. 　van der Molen AJ, Cowan NC, Mueller Lisse UG, et al. CT urography: definition, indication s and techniques. Aguide line for clinical practice[J]. Eur Radiol, 2008, 18 (1): 4-17.
13. 　Cheryl A. Sadow, Shane C. Wheeler, Jihoon Kim, et al. Positive predictive value of CT urography in the evaluation of upper tract urothelial cancer[J]. AJR, 2010, 195(9): 337-343.
14. 　顧錢峰, 陳俊波, 任能. 多層螺旋CT尿路成像對(duì)原發(fā)性輸尿管癌的診斷價(jià)值[J]. 醫(yī)學(xué)影像學(xué)雜志, 2010, 20(1): 141-142.
15. 　Martingno P, Stacul F, Cavallaro M, et al. 64-Slice CT urography: 30 months of clinical experience[J]. Radiol Med, 2010, 115(6): 920-935.
16. 　Kawashima A, Vrtiska TJ, LeRoy AJ, et al. CT urography[J]. Radiographics, 2004, 24 (1): 35-54.
17. 　McCollough CH, Daly TR, King BF Jr, et al. An auxiliary CT tabletop for radiography at the time of CT[J]. J Comput Assist Tomogr, 2001, 25(6): 876-880.
18. 　楊辰瑤, 王國(guó)年, 楊爍慧, 等. IVP、CTU和MRU在泌尿系結(jié)石的應(yīng)用價(jià)值[J]. 中國(guó)保健營(yíng)養(yǎng), 2009, 44(2): 44-45.
19. 　Nolte-Emsting C, Cowan N. Understanding multislice CT urography techniques: many roads lead to Rome[J]. Eur Radiol, 2006, 16(12): 2670-2686.
20. 　Coppenrath E, Meindl T, Herzng P, et al. Dose reduction in multidetector CT of the urinary tract. Studies in aphantom model[J]. Eur Radioi, 2006, 16(9): 1982-1989.
21. 　Martingno P, Stacul F, Cavallaro MF, et al. 64-Slice CT urography: optimisation of radiation dose[J]. Radiol Med, 2011, 2(1): 120-134.
22. 　Stacul F, Rossi A, Cova MA. CT urography: the end of IVU? [J]. Radiol Med, 2008, 1(13): 658-669.
  1. 1. 　陶然, 趙躍華, 劉金, 等. 螺旋CT多層面和多維重建在泌尿系疾病診斷中的應(yīng)用[J]. 中華泌尿外科雜志, 2007, 28(6): 382-338.
  2. 2. 　Caoili EM, Cohan RH, Korovkin M, et al. Urinary tract abnormalities: initial experience with multidetector row CT urography[J]. Radiology, 2002, 222(2): 353-360.
  3. 3. 　舒紅格, 漆劍平, 黃文華, 等. MSCT尿路成像診斷泌尿系統(tǒng)疾病: 與IVP檢查的對(duì)比研究[J]. 放射學(xué)實(shí)踐, 2006, 21(5): 468-470.
  4. 4. 　黃忠雄, 何玉成, 胡六才, 等. 16 層螺旋CT尿路三維重建在泌尿系梗阻性疾病診斷中的價(jià)值[J]. 放射學(xué)實(shí)踐, 2008, 26(1): 59-61.
  5. 5. 　Rimondini A, Morra A, Bertolotto M, et al. Spiral CT with multiplanar reconst ructions (MPRS) in the evaluation of ureteral neoplasms: preliminary results[J]. Radiol Med, 2001, 101(6): 459-465.
  6. 6. 　張瑜, 李霄麟, 于紅, 等. 多層CT尿路造影: 一種改良尿路顯影法的初步應(yīng)用[J]. 中國(guó)計(jì)算機(jī)成像雜志, 2009, 15(4): 385-388.
  7. 7. 　李澄, 王禮同, 湯曉明, 等. 多層螺旋CT曲面重建尿路成像技術(shù)的應(yīng)用[J]. 放射學(xué)實(shí)踐, 2004, 19(9): 644-646.
  8. 8. 　徐怡, 王小寧, 唐立鈞, 等. MSCTU對(duì)泌尿系統(tǒng)先天性疾病的診斷價(jià)值[J]. 中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志, 2006, 12(1): 40-43.
  9. 9. 　徐學(xué)勤, 董海鵬, 陳克敏, 等. 尿路病變CT尿路造影的臨床應(yīng)用[J]. 中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志, 2008, 14(3): 213-216.
  10. 10. 　李松年. 中華影像醫(yī)學(xué)泌尿生殖系統(tǒng)卷[M]. 北京: 人民衛(wèi)生出版社, 2002: 78.
  11. 11. 　王萬(wàn)勤, 劉斌, 余永強(qiáng), CT尿路成像技術(shù)現(xiàn)狀[J]. 國(guó)際醫(yī)學(xué)放射學(xué)雜志, 2009, 32(51): 467-470.
  12. 12. 　van der Molen AJ, Cowan NC, Mueller Lisse UG, et al. CT urography: definition, indication s and techniques. Aguide line for clinical practice[J]. Eur Radiol, 2008, 18 (1): 4-17.
  13. 13. 　Cheryl A. Sadow, Shane C. Wheeler, Jihoon Kim, et al. Positive predictive value of CT urography in the evaluation of upper tract urothelial cancer[J]. AJR, 2010, 195(9): 337-343.
  14. 14. 　顧錢峰, 陳俊波, 任能. 多層螺旋CT尿路成像對(duì)原發(fā)性輸尿管癌的診斷價(jià)值[J]. 醫(yī)學(xué)影像學(xué)雜志, 2010, 20(1): 141-142.
  15. 15. 　Martingno P, Stacul F, Cavallaro M, et al. 64-Slice CT urography: 30 months of clinical experience[J]. Radiol Med, 2010, 115(6): 920-935.
  16. 16. 　Kawashima A, Vrtiska TJ, LeRoy AJ, et al. CT urography[J]. Radiographics, 2004, 24 (1): 35-54.
  17. 17. 　McCollough CH, Daly TR, King BF Jr, et al. An auxiliary CT tabletop for radiography at the time of CT[J]. J Comput Assist Tomogr, 2001, 25(6): 876-880.
  18. 18. 　楊辰瑤, 王國(guó)年, 楊爍慧, 等. IVP、CTU和MRU在泌尿系結(jié)石的應(yīng)用價(jià)值[J]. 中國(guó)保健營(yíng)養(yǎng), 2009, 44(2): 44-45.
  19. 19. 　Nolte-Emsting C, Cowan N. Understanding multislice CT urography techniques: many roads lead to Rome[J]. Eur Radiol, 2006, 16(12): 2670-2686.
  20. 20. 　Coppenrath E, Meindl T, Herzng P, et al. Dose reduction in multidetector CT of the urinary tract. Studies in aphantom model[J]. Eur Radioi, 2006, 16(9): 1982-1989.
  21. 21. 　Martingno P, Stacul F, Cavallaro MF, et al. 64-Slice CT urography: optimisation of radiation dose[J]. Radiol Med, 2011, 2(1): 120-134.
  22. 22. 　Stacul F, Rossi A, Cova MA. CT urography: the end of IVU? [J]. Radiol Med, 2008, 1(13): 658-669.