三维排泄性对比增强磁共振尿路造影联合MRU对上尿路先天异常的诊断价值研究  

Diagnostic value of 3D-excretory contrast-enhanced MR urography combined with MR urography in congenital malformation of upper urinary tract

作　　者：李颢[1] 莫茵[2] 罗钰辉[1] 何波[2] 刘孝东[1] 申吉泓[1] 

机构地区：[1]昆明医科大学第一附属医院泌尿外科,昆明650032 [2]昆明医科大学第一附属医院影像中心

出　　处：《临床泌尿外科杂志》2012年第6期445-449,共5页Journal of Clinical Urology

基　　金：云南省教育厅科学研究基金(编号09Y0161)

摘　　要：目的:探讨三维排泄性对比增强磁共振尿路造影(3D-ceMRU)联合MRU在上尿路先天异常诊断中的价值。方法:对42例上尿路先天异常患者皆行MRU及3D-ceMRU扫描,与临床最终诊断对照后,评价3D-ceMRU联合MRU对上尿路先天异常的诊断价值,将3D-ceMRU及MRU对患侧上尿路的显影情况做对比分析。结果:3D-ceMRU联合MRU可清晰显示全部42例上尿路先天性异常,3D-ceMRU和MRU对42例上尿路先天异常患者的定性诊断率分别为90.5%、73.8%,定位诊断率分别为83.3%、64.3%。正常和轻度积水的上尿路3D-ceMRU图像质量优于MRU(P<0.01),而中-重度积水的上尿路MRU图像质量优于3D-ceMRU(P<0.01)。结论:3D-ceMRU联合MRU对上尿路先天异常具有较高的定位、定性诊断准确性,是诊断上尿路先天异常的可靠方法。Objective：To evaluate the clinical application value of 3D-excretory contrast-enhanced magnetic res- onance urography（3D-ceMRU） combined with magnetic resonance urography（MRU） in diagnosing congenital mal- formation of upper urinary tract. Methods.. Forty-two patients with congenital malformation of upper urinary tract were performed by MRU and 3I^ceMRU. 3D-ceMRU was performed by 3D SPGR, and 3D reconstruction from multiple images were acquired by maximum intensity projection algorithm. Contrast to the clinical final diagnosis, the accurate rate in diagnosis of congenital malformation of upper urinary tract by 3D-ceMRU combined with MRU was analyzed. Two readers independently scored each affected upper urinary tract for visualization degree which was compared between 3D-ceMRU and MRU. Results： The congenital malformation of upper urinary tract were definitely diagnosed with 3D-eeMRU combined with MRU in all 42 patients. The total correct rates of definitive diagnosis and locating diagnosis checked by 3D-ceMRU and MRU..were 90.5~/{, 73.8% and 83.3%, 64.3% re- spectively. The scores of aD-ceMRU were higher than MRU in the nondilated and mildly dilated upper tracts（P% 0.01）, but the scores of MRU were higher than 3D-ceMRU in the moderately dilated and markedly dilated upper tracts（P%0.01）. Conclusians： The combination of 3D-ceMRU and MRU can directly and clearly show the site and shape of congenital malformation of the upper urinary tract, it has excellent accuracy in the diagnosis of congenital malformation of upper urinary tract.

关 键 词：上尿路先天异常 磁共振成像 尿路造影术 

分 类 号：R692.1[医药卫生—泌尿科学]