术前磁共振水成像在外伤性尿道狭窄的应用价值  

Value of Preoperative Magnetic Resonance Hydrography for Traumatic Urethral Stricture

作　　者：王荣江[1] 李辉[1] 翁卿吉[1] 陈晓农[1] 邵四海[1] 

机构地区：[1]浙江省湖州市第一人民医院泌尿外科,湖州313000

出　　处：《中国微创外科杂志》2010年第10期875-876,879,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨磁共振水成像（magnetic resonance hydrography,MRH）在术前复杂性外伤后尿道狭窄中的应用价值。方法 2003年6月~2008年12月对25例外伤性尿道狭窄经尿道注入生理盐水,使用PHLIPS1.5TMRI机器,先常规磁共振（magnetic resonance imaging,MRI）检查,采用自旋回波技术序列矢状位、冠状位、横断位T1WI、T2WI扫描成像,再行MRH检查,经尿道注入生理盐水,采用快速自旋回波技术及脂肪抑制技术行重T2WI成像。所有病例常规X线尿道造影,并外科手术评估。结果 MRH和X线尿道造影显示狭窄部位的定位准确率分别为96.0%（24/25）、92.0%（23/25）,无统计学差异（χ2=0.350,P=0.552）;狭窄长度分别为（1.92±0.90）cm、（1.53±0.67）cm,与手术测值（1.98±0.91）cm无统计学差异（t=0.235,P=0.815;t=2.008,P=0.051）;22例MRH显示瘢痕范围（0.86±0.57）cm,与手术测值（0.98±0.59）cm无统计学差异（t=0.714,P=0.479）,X线尿道造影未能显示瘢痕。结论 MRH是安全、有效的非侵袭性影像检查方法,结合常规MRI对尿道狭窄可获得很好的定位及定性诊断价值,并提供更全面的瘢痕病变信息。Objective To evaluate the clinical application value of magnetic resonance hydrography（MRH） in the preoperative examination of complicated traumatic urethral stricture. Methods A total of 25 patients with traumatic urethral stricture were injected with physiological saline into the urethra,and then were studied preoperatively with spin-echo（SE） conventional by sagittal,coronal and axial T1-and T2-weighted sequence,afterward with fast spin-echo（FSE） heavily T2-weighed sequence and fat suppression pulse technique.All the patients underwent conventional radiographic urethrography（RUG） and surgical evaluation after the preoperative examination. Results The accuracy of MRH and RUG in evaluating the strictures position was 96.0%（24/25） and 92.0%（23/25） respectively（χ2=0.350,P0.05）.The length of the strictures was（1.92±0.90） cm and（1.53±0.67） cm respectively shown by the two examination techniques,which were similar to that determined during the operation [（1.98±0.91） cm;t=0.235,P=0.815;t=2.008,P=0.051].MRH showed a scar range of（0.86±0.57） cm in 22 patients,which was not significantly different from that detected during surgery [（0.98±0.59） cm,t=0.714,P=0.479],while RUG couldn＇t show scar range. Conclusion As an effective,safe and non-invasive imaging means,MRH can provide accurate location and quality of diagnosis and more comprehensive information about periurethral fibrosis in traumatic urethral stricture when combined with conventional MRI.

关 键 词：磁共振水成像 尿道狭窄 X线尿道造影 

分 类 号：R699[医药卫生—泌尿科学]