低张利尿法多层螺旋CT诊断输尿管病变的临床应用  

The application of hypotonic diuretics way for the diagnosis of ureter disease with multislice spiral CT

作　　者：冯军[1] 

机构地区：[1]湖南省岳阳市华容县人民医院CT室,414200

出　　处：《中国医疗前沿》2011年第16期60-61,共2页China Healthcare Innovation

摘　　要：目的探讨低张利尿法多层螺旋CT(MSCT)非增强扫描诊断输尿管病变时的临床价值。方法输尿管病变疑似患者57例,依次予以Siemens SOMATOM Sensation 16层螺旋CT机常规非增强尿路扫描,2-5d后,再注射低张利尿药物后行16层螺旋CT非增强尿路扫描。在Volume Wizard工作站上做CT输尿管曲面重组(CPR),对比两次扫描输尿管显示优良率;并对比两者对于输尿管病变的临床诊断准确率。统计学分析采用方差分析。结果低张利尿MSCT的CPR输尿管优良率明显高于非低张利尿MSCT的CPR输尿管优良率,其中患侧分别为86.0%和49.2%(P<0.05),健侧分别为82.5%和12.3%(P<0.05),差异显著。两者对于输尿管结石、肿瘤及输尿管畸形的诊断准确率无明显差异。但对于炎性狭窄者,常规MSCT是20%(3/15例),低张利尿MSCT是66.7%(10/15例),差异显著(P<0.05)。尤其是输尿管梗阻以下者,非低张利尿MSCT发现0例,而低张利尿MSCT发现7例。结论低张利尿法MSCT扫描能更清楚地显示全程输尿管,简便易行,重复性好,并能提高输尿管病变的临床诊断,值得基层医院推广。Objective To explore the clinical value of the hypotonic diuretics way for the diagnosis of the ureter disease with noncontrast multislice spiral CT（MSCT）.Methods 57 cases of probable ureter disease,of whose urinary tract MSCT were performed with Siemens SOMATOM Sensation 16 slice spiral CT,2-5days later,urinary tract MSCT were performed again after hypotonic diuretics medicine were taken.Postprocess were performed at the Volume Wizard workstation,and the CPR was taken along the ureter tract.The different quality of ureter imaging between the two examinations,also the clinical diagnosis data were analsized with one-way ANOVA.Results The excellence rat of hypotonic diuretics MSCT group is higher than MSCT group in CPR ureter reconstruction.The diseased ureter is respectively 86.0% and 49.2%（P0.05）,while the normal ureter is 82.5% vs 12.3%（P0.05）.No significant difference is found between them in ureteral calculus,ureteral tumor and deformity.However in inflammatory stricture of the ureter,the diagnosis rate of normal MSCT group is significantly different than the hypotonic diuretics MSCT,20%（3/15 cases） vs 66.7%（10/15 cases）.Especially for the diseases under the inflammatory stricture,no one case is found in normal MSCT group,while 7 cases of hypotonic diuretics MSCT group.Conclusion The hypotonic diuretics MSCT can show a good imaging of ureteral track,and is easily conducted and repeated.It can enhance the clinical diagnosis of ureteral disease,so is suitable to widespread in county hospitals.

关 键 词：输尿管 体层摄影术 X线计算机 曲面重组 低张利尿 

分 类 号：R816.7[医药卫生—放射医学]