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1、MSCTU诊断泌尿系统先天性疾病的价值:与IVU、MRU对比研究作者:王尔祯周硕林美福陈彩龙周庆伟陈国宝【摘要】目的探讨多层螺旋CT尿路成像(MSCTU)在诊断泌尿系统先天异常方面的特点、成像方法及其临床应用价值,并将其与IVU、MRU进行比较。方法搜集4年间临床资料完整的泌尿系先天异常患者83例,对其影像资料进行对比分析。结果83例患者中,52例行IVU检查,40例行MSCTU检查,47例行MRU检查。IVU、MSCTU、MRU对泌尿系先天异常总的定性诊断的正确率分别为48.21%,95.83%,72%,
2、总的定位诊断的正确率分别为57.14%,100%,90%。对伴轻度上尿路梗阻病变的定性诊断正确率分别为46.67%,100%,33.33%,定位诊断正确率分别为53.33%,100%,66.67%。对伴中度上尿路梗阻病变的定性诊断正确率分别为75%,100%,75%,定位诊断正确率分别为87.50%,100%,93.75%。对伴重度上尿路梗阻病变的定性诊断正确率分别为32%,85.71%,90.90%,定位诊断正确率分别为40%,100%,100%。结论MSCTU对显示泌尿系先天异常的整体解剖形态和细微病理
3、变化能力强,能明显提高诊断率,可作为首选检查方法。MRU是一种安全可靠的、无创伤性的检查方法,不用对比剂,可显示尿路扩张情况、梗阻部位、梗阻端形态,尤其对碘过敏或IVU不显影、中重度肾积水的病人更为适用。10【关键词】体层摄影术;X线计算机;尿路造影术;磁共振成像;泌尿生殖系统畸形[Abstract]ObjectiveToevaluatetheimagingmethods,characteristics,diagnosticvalueofmulti-sliceCTurography(MSCTU)incong
4、enitalabnormitiesofurinarysystem,andtocompareitwithintravenousurography(IVU)andMRurography(MRU).MethodsTocollect83urinarycongenitalabnormitiescasesinfouryears,thedatawereanalyzed.Severaltechniques,includingmultiplanarreformation(MPR),curvedplanarreformatio
5、n(CPR),volumerendering(VR),maximumintensityprojection(MIP)andvirtualendoscopy(VE)werepost-processedbyusingcommercialsoftware(ADW4.2).ResultsAtotalof83patientswithurinarycongenitalabnormitiesreceivedIVU(n=52),MSCTU(n=40)andMRU(n=47).ByIVU,MSCTU,MRU,thetotal
6、correctratesofdefinitivediagnosiswere48.21%,95.83%,72%,thetotalcorrectratesoflocatingdiagnosiswere57.14%,100%,90%.Withlow-gradeupperurinarytractobstruction,thecorrectratesofdefinitivediagnosiswere46.67%,100%,33.33%,thecorrectratesoflocatingdiagnosiswere53.
7、33%,100%,66.67%.Withmiddle-gradeupperurinarytractobstruction,thecorrectratesofdefinitivediagnosiswere75%,10100%,75%,thecorrectratesoflocatingdiagnosiswere87.5%,100%,93.75%.Withmarked-gradeupperurinarytractobstruction,thecorrectratesofdefinitivediagnosiswer
8、e32%,85.71%,90.90%,thecorrectratesoflocatingdiagnosiswere40%,100%,100%.ConclusionMSCTUhasclear,dimensionalfeatureandhasstrongabilityofdisplayingtotalanatomyshapeandtinypathologychangeofcongenitalabnormitiesin