摘要
目的比较静脉肾盂造影(IVU)、多层螺旋CT尿路造影(SCTU)及磁共振泌尿系水成像(MRU)对梗阻性尿路疾病的诊断能力,为临床选择合理检查方案提供理论依据。方法对62例经手术病理或经临床治疗随访证实的梗阻性尿路疾病患者影像资料进行回顾性分析,本组病例均行IVU检查,25例患者行SCTU检查,49例患者行MRU检查,12例患者同时行上述3种方法检查。结果 8例肾盂-输尿管移行部狭窄,IVU显示2例,7例包括IVU未显示病例MRU可清晰显示,1例CTU显示不清,不能明确诊断;19例输尿管结石病例,IVU显示9例,10例IVU未显示梗阻原因患者行CTU检查均清晰显示,13例行MRU检查,7例显示;15例输尿管肿瘤,7例行CTU检查,12例行MRU检查均显示清晰;11例输尿管外源性压迫或侵犯病例,IVU表现为肾积水,3例行CTU检查,10例行MRU检查均可清晰显示;9例输尿管炎性病变,IVU表现为肾积水,4例行CTU检查,2例显示清晰,2例与肿瘤不易鉴别,7例行MRU检查,均显示清晰。结论 IVU在梗阻性尿路疾病中主要用来筛查,当怀疑梗阻原因是结石引起时,应首选CTU检查,当怀疑梗阻原因是先天狭窄或肿瘤性病变时应首选MRU。
Objective To compare the diagnostic capability between intravenous urography（IVU）,multislice spiral computed tomography urography（SCTU） and static-liquid magnetic resonance urography（MRU）for obstructive uropathy and to provide the theoretic evidence for clinically selecting the optimal examined technique.Methods Sixty-two patients with surgically,pathologically or clinically followed-up proved obstructive uropathy underwent IVU,of whom,25 patients underwent additional SCTU,49 patients underwent additional MRU,and 12 patients simultaneously underwent above three techniques.The data acquired from three techniques were retrospectively analyzed and compared each other in all patients.Results In 8 patients with pelvi-ureteric junction stenosis,IVU showed 2 cases,MRU showed 7 cases who were negative on IVU,only 1 case could be not definitely diagnosed due to no lesion was found on SCTU.In 19 patients with ureteric stones,IVU showed 9 cases,SCTU clearly showed 10 cases whose obstructive cause could be not demonstrated by IVU,7 of 13 underwent MRU were clearly showed.In 15 patienta with ureteric tumors,7 cases who underwent SCTU and 12 cases underwent MRU were clearly showed.In 11 patients with ureteric exogenous compression or invasion,IVU showed hydronephrosis,3 cases who underwent SCTU and 10 cases who underwent MRU were clearly showed.In 9 patients with ureteric inflammation,IVU showed hydronephrosis,2 of 4 underwent SCTU were clearly showed but other two cases were difficultly differentiated from tumor,7 cases who underwent MRU were clearly showed.Conclusion IVU should be mainly used for conventional screening of obstructive uropathy,when the obstructive cause is suspected to be stones,SCTU should be taken as a first choice,when the obstructive cause is considered to be congenital stenosis or tumorous lesion,MRU should be taken as an optimal choice.
出处
《实用医学影像杂志》
2011年第5期311-313,335,共4页
Journal of Practical Medical Imaging
