128层CT尿路成像对非结石性尿路梗阻的临床应用价值  

Value of 128-slice CT urography in the diagnosis of non-calculous urinary tract obstruction

作　　者：赵红军[1] 李树昌[1] 苏炜[1] 韩云鹏[1] 张琳琳[1] 于凤凯[1] 隋如新[1] ZHAO Hongjun;LI Shuchang;SU Wei;HAN Yunpeng;ZHANG Linlin;YU Fengkai;SUI Ruxin(Department of Radiology,the Third People’s Hospital of Dalian,Dalian 116033,China)

机构地区：[1]大连市第三人民医院放射科,辽宁大连116033

出　　处：《大连医科大学学报》2019年第1期27-32,共6页Journal of Dalian Medical University

摘　　要：目的探讨128层CT尿路成像对非结石性尿路梗阻诊断的临床应用价值。方法对190例非结石性尿路梗阻患者,行CT薄层平扫及多时相CT增强扫描,数据经工作站后处理重建获得CTU图像。对尿路梗阻部位及程度、肾周渗出程度、肾功能受损程度进行分析。结果所有病例CTU图像均对梗阻的病因有明确的定位和定性,梗阻部位的形态及周围组织结构显示清晰,对扩张的尿路整体形态显示良好。190例中膀胱癌51例,输尿管癌45例,腹膜后转移瘤23例,结肠癌15例,直肠癌11例,宫颈癌10例,血管压迫8例,肾盂癌8例,卵巢癌7例,先天发育畸形6例,膀胱炎3例,输尿管炎2例,腹膜后纤维化1例。其中病变在输尿管中、下段及膀胱入口处造成中度梗阻51例,重度梗阻119例;肾周渗出共57例,其中A级29例,B级24例,C级4例;肾功能受损37例,其中轻度18例,中度10例,重度9例。结论 128层CT尿路成像对非结石性尿路梗阻性疾病的定位、定性以及梗阻程度、肾周渗出程度及肾功能的评价具有较高的临床应用价值。Objective To explore the value of 128-slice CT Urography in diagnosis of non-calculous urinary tract obstruction.Methods Totally 190 patients with non-calculous urinary tract obstruction underwent the thin-sliced and multi-phase contrast-enhanced CT scan.The CTU images were obtained through an independent workstation.The location and degree of urinary tract obstruction,the degree of perienal effusion and the degree of renal impairment were analyzed.Results All cases were confirmed by surgery or clinical data.Of the 190 patients,there were 51 cases of bladder cancer,45 ureteral carcinoma,23 retroperitoneal metastatic tumor,15 colon cancer,11 rectal cancer,10 cervical cancer,8 vascular compression,8 renal pelvic carcinoma,7 ovarian cancer,6 congenital abnormality,3 cystitis,2 ureteritis,and 1 retroperito-neal fibrosis.Among them,there were 51cases of moderate obstruction in the middle and lower ureter and bladder outlet,severe obstruction in 119 cases,57 cases of perirenal exudation including A grade 29 cases,B grade 24 cases,and C grade 4 cases;37 cases of impaired renal function including mild 18 cases,moderate 10 cases,and severe 9 cases.Conclusion 128-slice CT urography has high clinical value in the localization,characterization and evaluation of the degree of obstruction,perirenal exudation and renal function of non-calculous urinary tract obstruction diseases.

关 键 词：尿路梗阻疾病 尿路造影 CT成像 电子计算机体层扫描 

分 类 号：R445.3[医药卫生—影像医学与核医学]