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目的探讨多排螺旋CT纵剖面重建对输尿管梗阻性疾病的诊断价值。方法应用Lightspeed16螺旋CT机,对34例输尿管梗阻性病变的病人进行轴位面扫描,并对所得数据进行纵剖面重建。所有病例除2例腹膜后淋巴管转移致输尿管受压外,均经手术病理证实。结果34例患者中,输尿管结石22例,输尿管炎症2例,输尿管癌3例,肾盂输尿管连接处狭窄3例,输尿管囊肿1例,下腔静脉后输尿管1例,腹膜后淋巴结转移压迫输尿管者2例。CT纵剖面重建可显示输尿管腔内结石22处,输尿管管壁增厚者5例。增强扫描的5例病人中,CT值增加约20～35HU,延迟扫描18例表现为轻度积水,6例表现为中度积水,2例表现为重度积水,1例无积水。结论纵剖面重建图像对输尿管梗阻性病变的诊断具有较高的临床应用价值。
Objective To investigate the diagnostic value of multi-slice spiral CT longitudinal section reconstruction for ureteral obstruction. Methods 34 patients with obstructive ureteral obstruction were scanned with axial planes using Lightspeed16 spiral CT machine and the longitudinal section of the data was reconstructed. All cases except for 2 cases of retroperitoneal lymphatic metastasis caused by ureteral compression, were confirmed by surgical pathology. Results Of the 34 patients, 22 had ureteral calculi, 2 had ureteral inflammation, 3 had ureteral carcinoma, 3 had ureteropelvic junction stenosis, 1 had ureteral cyst, 1 had inferior vena cava ureter, 2 had retroperitoneal lymph node metastasis with ureter example. CT longitudinal section reconstruction can show ureteral calculi in 22 cases, 5 cases of ureteral wall thickening. Among the 5 patients who underwent enhanced scan, the CT value increased by about 20 ~ 35HU, delayed scan showed mild hydrocephalus in 18 cases, moderate effusion in 6 cases, severe hydrocephalus in 2 cases and no water in 1 case. Conclusion Longitudinal reconstructed images have high clinical value in the diagnosis of ureteral obstruction.