摘要
目的：探讨多层螺旋CT尿路成像（MSCTU）在肾盂、输尿管、膀胱尿漏中的诊断价值。方法：对15例经临床证实发生尿漏的患者进行三期MSCTU检查,采用多种CT图像后处理技术（MPR、MIP、VR）综合分析其MSCTU表现特点。结果：15例尿漏患者中,肾盂尿漏5例,输尿管漏8例,膀胱漏2例。尿漏患者MSCTU的排泄期表现为对比剂外溢,MIP、VR并结合MPR可以清晰显示漏口的部位及范围,并可显示伴发的肾实质破裂,肾包膜下血肿、肾周间隙积液、原发肿瘤（宫颈癌转移瘤侵及右输尿管）及泌尿系先天畸形等。结论：多层螺旋CT尿路成像（MSCTU）能清晰显示尿漏的部位、漏口并初步判断尿漏发生的原因,可以作为诊断尿漏的首选方法。
Objective：To explore the diagnostic value of multi-slice CT urography （MSCTU） in the urine leakage. Methods：15 cases of urine leaks confirmed by clinical diagnosis underwent spiral CT plain scanning and triphasic dynamic enhancement scanning.The CT features on axial images and multiplanar reformation （MPR）,maximum intensity projection （MIP） and volume rendering （VR） were reviewed.Results：The breakage in renal parenchyma,subcapsular hematoma of kidney,prerenal fascia thickening appeared in 5 cases with pelvis leak affected by trauma.The excretory phase could detect the leakage clearly,MIP and VR could show the lake of contrast agent.Of 8 cases with ureteral leakage,1 case by trauma damaging the right ureter,1 case by EWSL damaging the right ureter,and 1 case invaded by cervical cancer metastasis,a large number of retrorenal space fluid accumulation,the spills of contrast agent in excretory phase,and the contrast agent deposition in hydrops could be seen,sagittal MPR and VR clearly indicated the leakage,1 case with the left pelvic ectopic kidney and ectopic ureter opening in the vagina,MPR and MIP could show that vaginal ureteral access in excretory phase.4 cases with duplication of kidney,their additional ectopic ureter opened in the part of the prostate.1 case with bladder leak had the defect of posterior wall,encapsulated effusion in rectal bladder space and eggshell-like calcification of the wall could be found, the contrast agent inpoured the urinary vesicle through the defect of the bladder wall . Conclusion：Since the multi-slice CT urography （MSCTU） examination clearly shows the leakage,the site of urine leakage,the scope of urinary vesicle and other complications,it can be used as a preferred diagnostic method of urinary leakage.
出处
《放射学实践》
北大核心
2010年第8期904-907,共4页
Radiologic Practice
