IVP显示不良后CT检查的价值  

Usefulness of CT in remedying poor devel-opment of intravenous pyelography

作　　者：黄正林[1] 肖格林[1] 余水全[1] 刘锋[1] 李水连[1] 陈志明[1] 郑建夫[1] 傅万红[1] 

机构地区：[1]广州中医药大学附属中山医院放射科

出　　处：《中国CT和MRI杂志》2005年第3期51-53,F003,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨静脉肾盂造影一侧或双侧尿路显示不良,2～8h后行CT平扫检查的诊断价值。方法23例静脉肾盂造影显示不良或无显示的患者,于造影后2～8h内接受CT平扫。尿路扩张明显者进行全尿路的曲面重建、多平面重组、容积再现、最大密度投影等成像处理。结果23例中,CT诊断14例为输尿管第二、三生理狭窄处细小结石,并伴有不同程度的尿路扩张;3例为肾结核自截和肾动脉狭窄所致单侧肾功能不良;2例为炎性输尿管狭窄;另有输尿管癌、神经源性膀胱、急性弥漫性肾盂肾炎、慢性肾盂肾炎并肾癌各1例。结论静脉肾盂造影失败时,CT的高密度分辨率可使含有低浓度对比剂的尿路成像,利用扩张积水的输尿管进行CT的多模式重建能够完整地显示尿路状况。静脉肾盂造影后数小时内进行CT平扫是静脉肾盂造影失败后最有效的补救的措施,是明确尿路梗阻和肾功能不良病因的最佳方法。Objective To evaluate usefulness of CT plain scan (2～8 hours later) inremedying poor development of intravenous pyelography (IVP). Methods 23 casesreceived CT plain scan 2～8 hours later in order to remedy poor development of IVP.Those with dilated urinary tract underwent image treatment measures as kidney-urter-bladder curve reconstruction, multi-surface reconfiguration, cubage recurrence andmaximum density project. Results 14 cases were with fine stone and dilated tract inthe second or third physiological ureteral stenosis, 3 with unilateral renal dysfunctiondue to renal tuberculosis or renal arteriostenosis, 2 with inflammatory ureter stenosis, 1with ureter cancer, 1 with neurogenic bladder, 1 with acute diffuse pyelonephritis, and 1with chronic pyelonephritis complicated with renal carcinoma. Conclusion In caseVIP fails, ureter tract that contains low concentration contrast can develop under CT withhigh resolution. Dilated and water-retaining ureter tract can be completely displayed usingmulti-model reconstruction. CT plain scan is the most effective remedial to failure of VIPhelping make known pathogenesis of ureter obstruction and renal dysfunction.[

关 键 词：静脉肾孟造影 体层摄影术 X线计算机 IVP CT检查 肾功能 

分 类 号：R692[医药卫生—泌尿科学] R814.42[医药卫生—外科学]