摘要
目的通过16层CT泌尿系成像（CTU）研究肾盂、肾盏的解剖结构，探讨CTU在微创经皮肾镜碎石（MPCNL）穿刺定位中的应用价值。方法收集2004年9月至2005年3月，拟行MPCNL治疗的15例复杂肾结石患者，术前使用16层CT进行CTU检查，薄层重建横断面图像传入Brilliance Workspaee1．1工作站进行分析，以确定最佳穿刺径路。同时回顾分析同期接受CTU检查的30例患者的影像结果，对其肾盏、肾盂、集合系统的解剖结构进行研究，评价CTU在MPCNL穿刺定位中的作用。结果45例CTU均清晰显示肾盂、肾盏方向、形态、扩张程度及尿路引流情况。15例接受MPCNL的病例，根据CTU提供的信息预先确定穿刺径路和取石线路，穿刺定位时间明显缩短，穿刺、碎石成功率明显提高，除1例需辅助体外冲击波碎石术（ESWL）外，余14例均一期完全清除结石。结论多层CT泌尿系成像能准确显示全尿路的解剖结构，对MPCNL选择合适的穿刺径路具有指导意义。
Objective To study pelviealiceal anatomy using three-dimensional images derived by 16-slice multi detector CT urography （CTU）, and to discuss the role of CTU in planning for an optimal percutaneous approach into the pelviealiceal system （PCS） prior to minimally invasive pereutaneous nephrolithotomy （MPCNL）. Methods Fifteen patients with complex renal calculi were collected from September 2004 to March 2005 in order to choose an optimal percutaneous approach into the PCS prior to MPCNL, all consecutive patients received CTU examination with intravenous contrast administration, except patients who had allergy history or poor renal function. Reformatted CT urography was performed and data was analysed using Brilliance Workspaee 1.1. The role of pelvicaliceal map ping in MPCNL was evaluated. Three-dimensional images from 30 patients who were investigated using excretory urography were also reviewed for evaluating the anatomy of PCS. Results All 4.5 cases showed a good map of the PCS. All 15 patients who underwent MPCNL, CTU detected stones in all patients and accurately indicated their relation to the PCS, 14 had complete stone clearance, only 1 required ESWL for residual stone. Conclusions With reconstructed three-dimensional images, CTU could provide an advantage over conventional imaging in showing calculi and accurately showing their relation to the PCS. It also could provide essential information in choosing the optimal percutaneous approach into the PCS before MPCNL.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2007年第1期19-22,共4页
Chinese Journal of Urology
关键词
微创经皮
肾输尿管镜碎石
穿刺
体层摄影扫描仪
X线计算机
Minimally invasive percutaneous nephrolithotomy
Puncture technique
Tomo graphy scanners, X-ray computed
