CAJ | 학술논문

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.
목적 탐토다층라선CT뇨로성상(MSCTU)대인동비뇨계집합계통급수뇨관기형진단적최가소묘급도상후처리방법,병평고기진단개치.방법 수집행MSCTU다기소묘적집합관계통급수뇨관기형환자159례,분별계산MSCTU평소+다평면중조(MPR)、증강소묘피질기、수질기화배설기축위+도상후처리기술[MPR、최대강도투영(MIP)、용적재현(VR)]대비뇨계각충기형진단적준학솔.결과 159례환자중MSCTU평소+MPR화증강삼기소묘(피질기、수질기、배설기)축위+도상후처리기술(MPR、MIP、VR)적진단준학솔분별위:신우수뇨관이행부협착(63.49％、79.37％、87.30％、95.24％);신우수뇨관중복기형(17.54％、29.82％、29.82％、92.98％);단순수뇨관낭종(73.33％、73.33％、73.33％、100％);신외형신우(66.67％、66.67％、66.67％、83.33％).MSCTU평소가현시합병적결석,MSCTU증강소묘배설기MPR도상가분단추종현시수뇨관이위개구、수뇨관낭종등,차MIP급VR도상가직관、전모현시비뇨계관도계통.결론 MSCTU평소대비뇨계선천기형적진단개치유한,MSCTU다기상적증강소묘+도상후처리기술재진단인동비뇨계집합계통화수뇨관기형상유기독특적우세,가이작위진단적수선검사방법.
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.