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目的探讨多层螺旋CT尿路造影成像(CTU)方法对上尿路梗阻性疾病的诊断价值。方法收集我院2009年7月至2009年12月经多层螺旋CT尿路造影检查的49例患者的CTU影像资料及其中40例患者的泌尿系平片(KUB)加静脉尿路造影(IVU)检查影像学资料回顾性分析。所有49例病例均行平扫、动脉期、静脉期,延时期四期扫描,对所获容积数据进行三维重建处理。主要的重建方法有:最大密度投影、多平面重建、容积再现和曲面重建。然后分别分析CTU三维图像表现同KUB加IVU图像,做出影像诊断,追踪手术和病理诊断或临床治疗结果,比较两种观察手段在上尿路梗阻性疾病中的定位诊断符合率及定性诊断符合率,从而对CTU影像诊断方法真实性、可靠性及收益做出评价。结果 CTU图像质量优、良、差分别占样本总数的71.43%(35例)、26.53%(13例)、2%(1例);对上尿路梗阻性疾病的定位诊断符合率为100%,定性诊断符合率为93.88%。KUB加IVU组图像质量优、良、差分别占样本总数的20%(8例)、50%(20例)、30%(12例);对上尿路梗阻性疾病的定位诊断符合率为77.5%,定性诊断符合率为35%。CTU检查方法和KUB加IVU检查方法在诊断上尿路梗阻性疾病之间的差异有统计学意义(P<0.05)。结论CTU检查方法比KUB加IVU检查方法提供更多的诊断信息,并且能对上尿路梗阻性疾病做出较准确的定位、定性诊断,是值得临床应用和推广的泌尿系上尿路梗阻性病变的检查手段。
Objective To investigate the diagnostic value of multi-slice spiral CT urography in upper urinary tract obstructive diseases. Methods CTU imaging data of 49 patients who underwent multi-slice spiral CT urography from July 2009 to December 2009 in our hospital were collected, and 40 cases of urological plain film (KUB) plus intravenous urography (IVU) Check the imaging data retrospective analysis. All 49 cases underwent plain scan, arterial phase, venous phase and delayed phase four scan, and the obtained volume data were reconstructed by 3D reconstruction. The main reconstruction methods are: maximum density projection, multi-plane reconstruction, volume rendering and surface reconstruction. And then CTU three-dimensional image performance with KUB plus IVU images were analyzed to make imaging diagnosis, follow-up surgery and pathological diagnosis or clinical treatment results, the two observation means in the diagnosis of upper urinary tract obstruction in accordance with the diagnostic accuracy and qualitative diagnostic coincidence Rate, so as to evaluate the authenticity, reliability and profit of CTU imaging diagnosis method. Results The CTU image quality was excellent, good and bad respectively accounting for 71.43% (35 cases), 26.53% (13 cases) and 2% (1 case) of the total sample, and the coincidence rate of the localization diagnosis of upper urinary tract obstruction was 100% The coincidence rate of qualitative diagnosis was 93.88%. The image quality of KUB plus IVU group was excellent, good and bad respectively accounted for 20% (8 cases), 50% (20 cases) and 30% (12 cases) of the total samples. The coincidence rate of upper urinary tract obstruction diagnosis 77.5%, qualitative diagnosis coincidence rate of 35%. The difference between CTU examination and KUB plus IVU examination in the diagnosis of upper urinary tract obstruction was statistically significant (P <0.05). Conclusion CTU examination method provides more diagnostic information than KUB plus IVU examination method, and can make more accurate positioning and qualitative diagnosis of upper urinary tract obstruction disease, which is worthy of clinical application and promotion of upper urinary tract obstruction Disease examination means.