CTU及三维重建对小儿重肾与双输尿管畸形诊断价值.docVIP

CTU及三维重建对小儿重肾和双输尿管畸形诊断价值 　　作者：鹿洪亭，董蒨，杨传民，江布先，张虹，姜忠，郝希伟 鹿洪亭(1974)，男，硕士，主治医师。 作者单位：(青岛大学医学院附属医院小儿外科，山东 青岛 266003) 　　【摘要】 目的 探讨CT尿路造影(CTU)检查及三维重建对重肾及双输尿管畸形的临床诊断价值。方法回顾性分析28 例重肾、双输尿管畸形病人CTU检查及三维重建资料。病儿均应用64层螺旋CT 机对自肾上极至耻骨联合范围行CT 平扫和增强扫描，分别采用多平面重建(MPR)、最大密度投影(MIP)、曲面重建(CPR) 和容积再现(VR) 等软件进行图像处理。并与B超和手术结果比较。结果 CTU检查及三维重建图像能够清晰显示双肾盂、双输尿管扩张或梗阻的部位和程度, 本组28例先天性重肾、双输尿管畸形CTU检查及三维重建诊断结果全部与手术结果相符。结论 CTU检查及三维重建是重肾和双输尿管畸形一种重要的影像学诊断方法,能够准确作出诊断，并可指导术式选择。 　　【关键词】 体层摄影术,X线计算机;尿路造影术;泌尿生殖系统畸形;儿童 　　DIAGNOSTIC VALUE OF CTU WITH 3D RECONSTRUCTION FOR DUPLEX KIDNEY AND DOUBLE URETER 　　LU HONGTING, DONG QIAN, YANG CHUANMIN, et al 　　(Department of Pediatric Surgery, The Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, China); 　　[ABSTRACT] Objective To investigate the value of CT urography and 3D reconstruction in the diagnosis of duplex kidney and double ureter. Methods A retrospective analysis on CTU and 3D reconstruction data of 28 patients with duplex kidney and double ureter anormaly was conducted. All the patients underwent 64slice spiral CT scanning and enhancement scanning in the area from upper pole of kidney to symphysis pubis. 3D reconstructions were based on data of multiplanar reconstruction, maximal intensity projection, curved planar reformation and volume rendering processed with software. The CTU results were compared with ultrasound results and operative findings. Results CTU and 3D reconstruction clearly showed the location and degree of enlargement and obstruction in the duplex kidney and double ureters. The results of CTU of all the 28 cases were confirmed surgically. Conclusion CTU and 3D reconstruction were an important technique for diagnosis of duplex kidney and double ureters, as well as a guidance for the selection of operative modality. 　　[KEY WORDS] tomography, Xray computed; urography; urogenital abnormalities; child 　　以往对小儿先天性上尿路畸形的诊断主要依赖于B超、CT平扫及静脉泌尿道造影(IVU)等检查,但均有不足和局限性[1]。近5年来,在我院接受手术治疗的先天性重肾及双输尿管畸形