输尿管膀胱CT三维仿真成像技术探讨及临床应用  

Techniques and clinical applications of three-dimensional and virtual imaging in the diagnosis of ureterovesical diseases

作　　者：苑静波[1] 啜振华[1] 范晖[1] 翟保生[1] 刘荣欣[1] 王秀忠[1] 葛路岩[1] 

机构地区：[1]河北省石家庄铁路中心医院影像科,河北石家庄050011

出　　处：《医学影像学杂志》2003年第2期112-115,共4页Journal of Medical Imaging

摘　　要：目的 :探讨螺旋CT三维仿真内镜成像在输尿管膀胱疾病中的临床应用价值及有关成像技术。方法 :经静脉或经膀胱镜逆行注入碘水造影剂 ( 60 %泛影葡胺或欧乃派克 )充盈泌尿道 ,获取螺旋CT簿层扫描原始图像 ,重建后将图像源容积数据传输至同机工作站 (GEAdvantageWindows 3 .1)。应用机内软件系统进行图像后期处理 ,获取输尿管膀胱的多种三维立体及仿真内镜图像。结果 :膀胱肿瘤 5例 ,前列腺增生 8例 (其中 1例合并前列腺癌 ) ,输尿管狭窄 4例 ,神经原性膀胱合并输尿管扩张 1例。三维成像及仿真内镜可清晰显示膀胱肿瘤的形态、大小及位置 ,特别是与输尿管口及尿道内口的解剖关系 ;清晰显示膀胱小梁、膀胱憩室 ;显示输尿管的腔内情况及其三维立体形态。尿道内口显示率 10 0 % ,输尿管口的显示率 79%。结论 :输尿管膀胱CT三维仿真内镜成像技术可清晰显示泌尿道腔内及外表多种病理形态改变 ,与普通横断面CT相比能提供更多的诊断信息 ,在帮助临床制定治疗方案。Objective:To investigate the clinical value and technique of three-dimensional(3D) and virtual imaging with helical CT in the diagnosis of ureterovesical diseases.Methods: After the contrast medium (60%Urografin or Omnipaque) was introduced introvenously or by retrograde mode with urethrocyscoscope, the urinary tract was filled with organic iodine solution and thin-slice helical CT scanning was performed with the scanning parameters: slice 2.0～3.0mm, pitch 1.5.After reconstructed the initial volumetric imaging data was transferred to the workstation (GE Advantage Windows 3.1) and the images of 3D and (virtual endoscopy) VE of ureter and bladder were acquired by using analytic soft-ware and selecting suitable imaging mode and threshold values.Results:Bladder carcinoma was detected in five cases. 3D images exhibited the size, shape and location of the tumours and the relationship between the tumour and the ureterostoma as well as the internal orifice of the urethra was displayed very clearly. Hyperplasia of prostate was detected in eight cases,including one complicated with prostatic carcinoma.VE images exhibited the protrusive part of the prostate and the concomitant trabeculae and diverticula in bladder. Four cases with ureterostenosis and one cases with neurogenic bladder complicated with megaureter was also detected. The sensitivity of VE in displaying ureterostoma and internal orifice of urethra was 79% and 100%, respectively.Conclusion:3D and VE images may detect many ureterovesical morphologic changes in intra-cavity and appearance. With this technique more diagnostic information may be obtained than with conventional CT. As a new and reliable method it play an important role in selecting therapeutic measures as well as in predicting prognosis in patient with ureterocystic diseases.

关 键 词：输尿管膀胱 体层摄影术 X线计算机 三维成像 仿真内窥 

分 类 号：R816.7[医药卫生—放射医学]