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目的探讨多排螺旋CT尿路造影(MDCTU)在评价血尿原因中的应用价值。资料与方法对48例血尿患者行MDCTU检查和图像三维重组,重组方式包括容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)和曲面重组(CPR),并对其重组图像进行综合评估。然后将尿路系统分为梗阻组和非梗阻组,分别对其重组图像中的尿路解剖结构和尿路连贯性的显示效果进行对比分析。结果VR与MIP图像的显示效果依赖于管腔内对比剂充盈情况,MPR及CPR图像不依赖于管腔内对比剂充盈情况,两组间CPR对尿路连贯性的显示效果以及对尿路解剖结构的显示效果差异均无统计学意义,CPR的应用弥补了VR和MIP的不足,使整体观察效果得到了明显提高并有助于诊断。MDCTU的诊断准确率为97.8%(44/45)。结论MDCTU的图像质量好,对血尿原因的综合评价能力较强,在泌尿系统疾病检查中具有较好的应用价值和推广价值,当尿路有梗阻、肾功能差或输尿管收缩时,CPR有助于影像学诊断。
Objective To investigate the value of multi-slice spiral CT urography (MDCTU) in the evaluation of the causes of hematuria. Materials and Methods MDCTU examination and image 3D reconstruction were performed in 48 patients with hematuria. The reconstruction methods included volume rendering (VR), maximum density projection (MIP), multiplanar reconstruction (MPR) and surface reconstruction (CPR) Conduct a comprehensive assessment. Then, the urinary system was divided into obstructive group and non-obstructive group, and the comparative analysis of urinary tract anatomy and urinary tract consistency in their reconstructed images were carried out respectively. Results The display of VR and MIP images was dependent on the filling of contrast medium in the lumen. The MPR and CPR images did not depend on the filling of the contrast medium in the lumen. The display of CPR on urinary tract continuity and anatomy of the urinary tract The results showed that there was no significant difference in the display of the structure. The application of CPR made up for the deficiency of VR and MIP, and the overall observation effect was obviously improved and helped to diagnose. The diagnostic accuracy of MDCTU was 97.8% (44/45). Conclusion MDCTU has good image quality and strong comprehensive evaluation of the causes of hematuria. It has good application value and promotion value in the examination of urinary system diseases. When the urinary tract obstruction, renal function is poor or ureteral contraction, CPR is helpful Diagnostic imaging.