CAJ | 학술논문

目的探讨CT仿真输尿管膀胱镜成像技术和价值。方法应用螺旋CT采集排泄期尿路断面影像47例，层厚5mm，螺距2.0或1.0，重建层厚2.5mm；将源影像送至工作站作内窥镜成像等后处理。6例同时作了膀胱镜或输尿管镜检查。结果 CT-IVU和VE技术成功率达100%，无并发症。VE内镜样显示了肾盏、肾盂、输尿管和膀胱内壁、内腔及其病变的三维结构，对5mm以上膀胱癌检出率达100%，较好地显示了肿瘤特征，增加了诊断信息。但VE无法显示尿路结石和区分输尿管真性狭窄与正常蠕动波，在显示尿路内腔解剖和病变细节也无输尿管膀胱镜佳(P<0.05)。CT-IVU图像质量比常规静脉尿路造影（X-IVU）的佳(P<0.05)。结论CT-IVU内镜重建三维内镜样显示了尿路内腔与病变，对肿瘤病变准确性高，但无法检出尿路结石。CT-IVU优于X-IVU。
목적탐토CT방진수뇨관방광경성상기술화개치。방법응용라선CT채집배설기뇨로단면영상47례，층후5mm，라거2.0혹1.0，중건층후2.5mm；장원영상송지공작참작내규경성상등후처리。6례동시작료방광경혹수뇨관경검사。결과 CT-IVU화VE기술성공솔체100%，무병발증。VE내경양현시료신잔、신우、수뇨관화방광내벽、내강급기병변적삼유결구，대5mm이상방광암검출솔체100%，교호지현시료종류특정，증가료진단신식。단VE무법현시뇨로결석화구분수뇨관진성협착여정상연동파，재현시뇨로내강해부화병변세절야무수뇨관방광경가(P<0.05)。CT-IVU도상질량비상규정맥뇨로조영（X-IVU）적가(P<0.05)。결론CT-IVU내경중건삼유내경양현시료뇨로내강여병변，대종류병변준학성고，단무법검출뇨로결석。CT-IVU우우X-IVU。
Objective　To detect the techniques and clinical value of CT virtual endoscopy of urinary tracts. Methods　Virtual endoscopy(VE) of urinary tracts was performed in 47 cases, using navigator software based on the source imaging data of excretory helical CT urography(CT-IVU) with the following scanning parameters:slice 5mm,pitch 2.0 or 1.0. Images were reconstructed at 2.5mm interval. Excretory scout was done in 41 cases.Six cases were underwent meanwhile ureterorenoscopy or cystoscopy. Results　The technical success rate of CT-IVU and VE was 100% without any complication. The 3D display of Virtual ureterocystoscopy depicted endoscopelike the innerlumen anatomy and disorders of urinary tracts at any angle. The sensitivity of VE to bladder tumors more than 5 mm in diameter was 100%,with some tumor character. It added the diagnostic information to CT. It was difficult,however,for VE to detect the stones and to distinguish the normal uretal peristalses from stricture. Compared with ureterocystoscopy, the major limitation of CT virtual endoscopy was its inability to demonstrate the detail of lesions and mucosal surface of urinary tracts.The imaging quality of CT-IVU was better than that of X-IVU(P<0.05). Conclusion　CT ureterocystoscopy provides endoscope-like display of urinary tracts and lesions.The diagnostic accuracy of tumors,but stones， is higher. CT-IVU is superior to X-IVU.