MSCTU对儿童泌尿系集合系统及输尿管畸形的诊断价值

The diagnosis value of MSCTU in child congenital anomalies of urinary system

    摘要
  • 摘要:
    目的 探讨多层螺旋CT尿路成像（MSCTU）对儿童泌尿系集合系统及输尿管畸形诊断的最佳扫描及图像后处理方法，并评估其诊断价值。
    方法 收集行MSCTU多期扫描的集合管系统及输尿管畸形患者159例，分别计算MSCTU平扫+多平面重组（MPR）、增强扫描皮质期、髓质期和排泄期轴位+图像后处理技术MPR、最大强度投影（MIP）、容积再现（VR）对泌尿系各种畸形诊断的准确率。
    结果 159例患者中MSCTU平扫+MPR和增强三期扫描（皮质期、髓质期、排泄期）轴位+图像后处理技术（MPR、MIP、VR）的诊断准确率分别为：肾盂输尿管移行部狭窄（63.49%、79.37%、87.30%、95.24%）；肾盂输尿管重复畸形（17.54%、29.82%、29.82%、92.98%）；单纯输尿管囊肿（73.33%、73.33%、73.33%、100%）；肾外型肾盂（66.67%、66.67%、66.67%、83.33%）。MSCTU平扫可显示合并的结石，MSCTU增强扫描排泄期MPR图像可分段追踪显示输尿管异位开口、输尿管囊肿等，且MIP及VR图像可直观、全貌显示泌尿系管道系统。
    结论 MSCTU平扫对泌尿系先天畸形的诊断价值有限，MSCTU多期相的增强扫描+图像后处理技术在诊断儿童泌尿系集合系统和输尿管畸形上有其独特的优势，可以作为诊断的首选检查方法。

     

    Abstract:
    Objective To explore the best diagnostic scanning and image processing methods of multi-slice CT urography (MSCTU) in the detection of congenital anomalies of urinary system.
    Methods One hundred and fifty nine patients who suffered from the ureter and renal collecting duct system anomalies to be examined by MSCTU were collected and reviewed retrospectively.The diagnostic accuracy of congenital anomalies were calculated on the image of multi-planar reconstruction (MPR)+MSCTU unenhanced scanning and the image of post-processing technique of MPR, maximum intensity projection (MIP), volume rendering (VR)+enhanced cortical phase scanning, parenchymal phase scanning and excretory phase scanning.
    Results The diagnostic accuracy of the MSCTU unenhanced scanning+MPR and enhanced cortical phase scanning, parenchymal phase scanning, excretory phase scanning+the image of post-processing technique (MPR, MIP, VR) were:ureteropelvic junction obstruction (63.5%, 79.4%, 87.3%, 95.2%), renal pelvis ureteral duplication (17.54%, 29.82%, 29.82%, 92.98%), ureteral cyst (73.33%, 73.33%, 73.33%, 100%), extrarenal pelvis (66.67%, 66.67%, 66.67%, 83.33%).MSCTU plain film could show the stones in the urinary system.The MPR film of MSCTU enhanced excretory phase could show the ectopic ureter and ureteral cyst, and the MIP and VR images could visually show the whole structure of urinary system.
    Conclusions The MSCTU plain film in the diagnosis of congenital malformations of urinary system is of limited values, while the MSCTU film with image post-processing techniques in the diagnosis of congenital malformations of urinary system has their unique advantages, which can be used as a preferred method in examination.

     

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