尿漏的螺旋CT诊断  

The Spiral CT Diagnosis of Urine Leaks

作　　者：杨贤卫[1] 徐娀 张延伟[1] 郑芸[1] 朱丹[1] 许焕奇[1] 

机构地区：[1]广州中医药大学第一附属医院放射科,510405 [2]广东省高要人民医院CT-MRI室

出　　处：《临床放射学杂志》2007年第11期1116-1118,共3页Journal of Clinical Radiology

摘　　要：目的探讨螺旋CT扫描对肾盂、输尿管及膀胱尿漏的诊断价值。资料与方法搜集肾盂尿漏4例、输尿管尿漏1例、膀胱尿漏2例,全部行螺旋CT扫描,其中平扫2例,平扫、增强并延迟增强扫描5例,用最大密度投影(MIP)和曲面重组(CPR)进行重组,分析其CT特点。结果4例肾盂及1例输尿管尿漏均有肾周间隙包裹性积液(尿囊肿)与蜂窝织炎、肾周筋膜增厚,其中合并腹腔积液2例,胸腔积液1例。病变肾盂、输尿管管壁增厚、管腔扩张,增强扫描管壁明显强化。1例肾盂尿漏撕裂部位可见管壁缺损中断,4例增强延迟扫描CPR和MIP图像见对比剂外溢并明确显示撕裂口。2例膀胱尿漏均发生于腹膜内,显示为腹腔积液并局部腹膜炎表现,其中1例增强延迟扫描示膀胱顶壁对比剂外溢和腹腔积液密度增高。结论螺旋CT延迟扫描可准确显示尿漏的部位和尿囊肿的范围,对尿漏的诊断和制订治疗方案具有决定作用。Objective To discuss the diagnostic value of spiral CT in urine leaks. Materials and Methods Of 7 cases of urine leaks（including 4 cases with renal leaks, 1 case with ureter leaks and 2 cases with bladder leaks） , 2 cases were examined only with spiral CT plain scan, 5 cases with pre and post- enhanced scan. The CT features in maximum intensity projection（MIP） and curved planar reconstruction （CPR） images were reviewed. Results The encapsulated fluids （urinomas） and cellulitis in perirenal space, as well as the perirenal fascia thickening was noted in 4 cases of renal and 1 case of ureter leaks, combined with ascites in 2 cases, pleural effusion in 1 case. The involved pelvis or urter was dilatation, and the wall was swelling with enhancement. In the delayed phase, the lacerated orifices and leaking of contrast agent were visualized clearly in MIP and CPR images 5 - 210 minutes after contrast agent administration. 2 cases of bladder leaks occurred in the peritoneal cavity, and manifested as abdominal cavity fluids. In 1 case, the lacerated orifice of superior bladder wall was revealed as leaking of contrast agent and hyperdense ascites was visualized with delayed enhanced scan. Conclusion Delayed enhanced spiral CT examination could detect the lacerated orifice and show the urinomas definitely, which plays an important role in the diagnosis and the treatment plan of urine leaks.

关 键 词：尿漏 X线计算机体层摄影术 诊断 肾盂 输尿管 膀胱 

分 类 号：R816.7[医药卫生—放射医学]