多层螺旋CT平扫诊断急性梗阻性尿外渗应用分析  

Diagnosis of Acute Obstructive Urinary Extravasation by Non-contrast MSCT

作　　者：房伟[1] 李媛媛[1] 张友军[1] 

机构地区：[1]潍坊医学院附属益都中心医院CT科

出　　处：《中国医学计算机成像杂志》2010年第4期312-315,共4页Chinese Computed Medical Imaging

摘　　要：目的:探讨MSCT平扫对急性尿路梗阻并发尿外渗的诊断价值。方法:回顾性分析21例因急性腰腹痛就诊的患者,分别采用16排螺旋CT或双源CT机(Definition)平扫,图像后处理工作站应用多平面重建(MPR)及曲面重建(CPR)技术,其中的5例病人行增强扫描,附加容积再现(VR)图像后处理。结果:21例患者,19例尿路结石,2例输尿管癌,CT平扫均见患侧肾脏体积增大,密度减低,肾盂输尿管轻中度扩张积水,肾周积液。13例输尿管周围见液性渗出样密度影。MPR及CPR可更清楚显示全程梗阻表现及尿外渗征象。增强扫描后发现患侧肾脏强化较对侧延迟,延迟期可见条片状对比剂外渗。结论:MSCT平扫结合MPR及CPR图像后处理能清楚显示病变及梗阻原因,结合病史可诊断急性梗阻性尿外渗,避免应用对比剂对肾脏的损害和造成浪费。Purpose： To explore the diagnostic value of acute obstructive urinary extravasation by use of non - contrast multi - slice spiral CT. Methods： Twenty - one patients with acute lumbar pain were scanned by non - contrast 16 row spiral CT and dual source CT（Definition）, of which, 5 cases were enhanced scanned. The obtained data were reconstructed by multiple plannar reformation（MPR）, curved plannar reformation（CPR） and volume rendering （VR） . Results： Twenty - one cases, of which, 19 cases were urolithiasis, 2 cases were ureteral cancer. Unenhanced CT showed increase of kidney volume, decrease of density, mild hydronephrosis and hydroureter, perinephric effusion. The effusion was found around ureter in 13 cases. Acute obstructive urinary extravasation was clearly demonstrated by MPR and CPR. The strengthening of suffering kidney was delayed than opposite side after enhanced scan, and extravasation of contrast media was found in delay period. Conclusion： Unenhanced scan and MPR, CPR of MSCT can clearly demonstrate extent of the lesion and anatomical structures, and precisly diagnose urinary extravasation. It is helpful for clinical treatment.

关 键 词：尿路梗阻 尿外渗 X线计算机 体层摄影术 

分 类 号：R691.2[医药卫生—泌尿科学] R816.7[医药卫生—外科学]