排尿性MR尿道成像对损伤性尿道狭窄的诊断价值  

Value of MR urethrography during micturition in the diagnosis of urethral injury

作　　者：陶维静[1,2] 柏根基[2] 傅广波[3] 牛晓兵[3] 王恒兵[3] 王功成[3] 嵇卉[2] 胡春洪[1] TAO Wei-jing;BAI Gen-ji;HU Chun-hong(Department of Radiology,First Affiliated Hospital,Soochow University,Jiangsu 215000,China)

机构地区：[1]苏州大学附属第一医院,江苏215000 [2]南京医科大学附属淮安第一医院影像科,江苏223300 [3]南京医科大学附属淮安第一医院泌尿外科,江苏223300

出　　处：《放射学实践》2018年第11期1182-1186,共5页Radiologic Practice

基　　金：淮安市2015年科技计划项目(HA2015014-3)。

摘　　要：目的:探讨排尿性MR尿道成像对损伤性尿道狭窄的诊断价值。方法:对因排尿困难前来本院就诊的73例男性患者进行排尿性MR尿道成像,利用生理盐水或尿液充盈尿道,在患者排尿时进行MR平扫及增强扫描。所有患者均行X线尿道造影及手术治疗。观察尿道狭窄位置、程度、长度、有无瘢痕形成及其周围组织结构关系。对排尿性MR尿道成像、X线尿道造影所测得的尿道狭窄的长度与手术所见尿道狭窄的长度进行统计学分析。结果:57例后尿道狭窄,16例前尿道狭窄;12例尿道完全离断伴有断端错位,38例尿道闭锁无错位,14例尿道重度狭窄,9例尿道中度狭窄;损伤尿道周围均有不同程度瘢痕组织。排尿性MR尿道成像对尿道损伤的定位与X线尿道造影及术中所见结果一致,对尿道周围组织结构的显示与术中所见一致、明显优于X线尿道造影。对于尿道狭窄的长度的判断,MR尿道成像测得的狭窄长度[(1.634±0.6481)cm]与术中测得的狭窄长度[(1.615±0.6843)cm]差异无统计学意义(t=1.242,P=0.2183),X线尿道造影测得的狭窄长度[(2.100(1.990,2.290)cm]与术中测得的狭窄长度差异具有统计学意义(P<0.0001)。结论:排尿性MR尿道成像可以准确显示狭窄尿道及其周围组织结构,指导临床手术方式的选择。Objective:To study the value of MR urethrography during micturition in the diagnosis of urethral injury.Methods:73 male patients present in our hospital due to dysuria by urethral injury.All the patients underwent MR urethrography during micturition,as well as conventional urography and surgery.Using normal saline or urine for the filling of urinary tract,plain and enhanced MR scanning during micturition were performed.The location,length,and degree of urethral stricture as well as the scar formation and the relation with surrounding organ/structure were studied.Statistic analysis was performed to observe the length of urethral stricture measured by MR urethrography during micturition,conventional urography and surgery.Results:There were 57 patients with posterior urethral stricture and 16 patients with anterior urethral stricture;12 patients with complete rupture accompanied with dislocation of severed end,38 patients with urethral atresia yet without dislocation,14 patients with severe urethral stricture,and 9 patients with moderate urethral stricture.There were different degrees of scar tissue around the injured urethra.The positioning of the urethral injury displayed on MR urethrography during micturition and conventional urography was consistent with that of surgery.The surrounding scar tissue displayed on MR urethrography during micturition was consistent with that of surgery,and was much better than that of conventional urography.The length of the urethral stricture measured by MR urethrography during micturition was[(1.634±0.6481)cm],which shown no statistic difference with that measured by surgery[(1.615±0.6843)cm],(t=1.242,P=0.2183);yet which was significantly different when compared with that measured by conventional urethrography[(2.100(1.990,2.290)cm],(P<0.0001).Conclusion:Urethral stricture and its surrounding tissue and structure could be displayed more clearly and accurately by MR urethrography,which could be used as the guidance for the selection of surgery approach.

关 键 词：尿道损伤 尿道X线造影 磁共振尿道成像 尿道狭窄 

分 类 号：R445.2[医药卫生—影像医学与核医学] R695.4[医药卫生—诊断学]