多层螺旋CT尿路成像对输尿管恶性病变诊断价值.docVIP

多层螺旋CT尿路成像对输尿管恶性病变诊断价值【摘要】 目的 探讨多层螺旋CT尿路成像(MSCTU)对输尿管恶性病变的诊断价值。方法 37例输尿管恶性病变患者进行了MSCT检查,包括平扫、肾皮质期、肾实质期、肾盂排泄期扫描,再根据输尿管显影情况进行延迟扫描,将原始图像传输至工作站进行后处理获得MSCTU的图像资料。结果 本组病例中,输尿管癌12例,肾盂癌或膀胱癌累及输尿管13例,邻近组织恶性肿瘤侵犯输尿管12例,输尿管恶性病变在MSCTU主要表现为病变段输尿管软组织肿物影,管腔狭窄或闭塞,以及不同程度的尿路梗阻,各种重建方法可以三维显示病变的来源、部位、范围、程度等,并经手术病理证实。结论 MSCTU对输尿管恶性病变的定位、定性诊断有重要价值。 【关键词】输尿管;肿瘤;梗阻;多层CT Application of muti-slice CT urography to ureteral m alignant disorders DING Han-jun,GU Jie-hong,JIANG Xin-qing,et al.Department of Radiology, The Frist Hospital of Guangzhou,Guangzhou 510180,China 【Abstract】 Objective To assess the diagnostic value of multi-slice CT urography(MSCTU)in ureteral m alignant disorders.Methods 37 patients with ureteral m alignant disorders were reviewed in this study,witch including unenhancement scan,three-phases enhancement scan and delay-phase scan.The MSCTU images were obtained with the reconstruction of original data through the workstain.Results Among these patients,there were 12 cases of ureteral carcinoma,13 cases of ureter tumors involved by renal pelvic carcinomas or bladder carcinoma,12 cases of ureter mass involved by m alignant disorders of adjacent tissue.The MSCTU showed as soft tissue density tumor of ureter,stenosis or obstruction in ureter.MSCTU has displayed the source,position,range,extend of the ureteral disorders,and confirmed by the operation or pathology.Conclusion MSCTU is of great value in the diagnosis of ureteral m alignant disorders. 【Key words】Ureteral; Tumor; Obstruction; Multi-slice CT 作者单位:510180广州市第一人民医院放射科 输尿管恶性病变是引起输尿管梗阻的原因之一,传统的腹部平片、静脉尿路造影常无法明确诊断。近年来随着螺旋CT技术的成熟和三维重建功能软件的逐步完善,多层螺旋CT尿路成像(multi-slice CT urography,MSCTU)已应用于临床,本文旨在探讨MSCTU对输尿管恶性病变的诊断价值。 1 材料和方法 1.1 一般资料 收集我院2006年以来,经MSCTU检查诊断并经临床手术或病理证实的输尿管恶性病变的患者37例,男性23例,女性14例,年龄19~89岁(平均66岁),50岁以上患者占32例。临床症状以血尿及腰痛多见。患者均行常规X线检查,腹部平片无异常发现,IVP发现肾盂或输尿管积水14例,提示输尿管充盈缺损2例,显影浅淡或不显影23例。 1.2 扫描方法 采用日本东芝公司AQUILION 16排螺旋CT机,扫描范围自肾上极至耻骨联合,覆盖肾脏、输尿管和膀胱。患者检查前空腹4 h,饮水200 ml后适度憋尿。首先进行常规平扫,随后采用高压