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目的应用螺旋CT分析输尿管结石是否易停留在传统的输尿管3个狭窄部位,探讨螺旋CT与KUB评估结石大小的异同及临床意义。方法回顾性分析了206例输尿管结石患者的资料,每例均有螺旋CT扫描,其中52例螺旋CT结果与对应的KUB平片进行比较。结果 206例共227颗输尿管结石中,73颗(32.2%)位于传统认为的输尿管3个狭窄处,即输尿管膀胱壁段(UVJ)55颗(24.2%),肾盂输尿管连接处(UPJ)10颗(4.4%),输尿管跨越髂血管处(UEIV)8颗(3.5%)。大部分结石位于近段和远段输尿管,其中近段114颗(50.2%),远段输尿管为40颗(17.6%);螺旋CT扫描层数乘以层厚评估54颗输尿管结石长径(10.4±4.9)mm大于KUB上测出的长径(9.3±8.5)mm(P<0.05);CT测量出的结石最大横径为(7.1±3.9)mm,KUB上测量出的结石最大横径为(6.8±2.6)mm,两者无统计学差异(P>0.05)。结论输尿管结石的部位依次为:近段输尿管、UVJ与远段输尿管,仅少部分位于UPJ和UEIV处,与尿路结石易停留在生理狭窄的位置不完全相同;用螺旋CT扫描层数乘以层厚来评估结石长径大于KUB上测得的结石长径,但螺旋CT和KUB平片上测得的结石最大横径无显著差别。
Objective To analyze the similarities and differences between spiral CT and KUB in evaluating the size of stone and its clinical significance by using spiral CT to analyze whether ureteral calculi easily stay in the three traditional ureteral strictures. Methods A retrospective analysis of 206 cases of ureteral calculi in patients with data, each case has a spiral CT scan, of which 52 cases of spiral CT results with the corresponding KUB plain film for comparison. Results A total of 227 ureteral stones were found in 206 cases, of which 73 (32.2%) were located in the three traditional ureteral strictures: 55 (24.2%) of the ureteric wall segments (UUVA), 10 of the ureteropelvic junction (UPJ) (4.4%), ureter across the iliac vessels (UEIV) 8 (3.5%). Most of the stones were located in the proximal and distal ureters, 114 (50.2%) proximal and 40 distal ureteral (17.6%). Spiral computed tomography (CT) ± 4.9 mm) was larger than the long diameter (9.3 ± 8.5 mm) measured by KUB (P <0.05). The maximum diameter of calculus measured by CT was (7.1 ± 3.9) mm. The maximum diameter of calculus measured by KUB was (6.8 ± 2.6) mm, no significant difference between the two (P> 0.05). Conclusions Ureteral calculi are located in the proximal ureter, UVJ and distal ureter, with only a few located at UPJ and UEIV, which are not exactly the same as urinary calculi in physiological stenosis. Thickness of the stone to evaluate the length of the stone is larger than the diameter of KUB measured on the stone, but the spiral CT and KUB plain film measured the maximum diameter of the stone no significant difference.