摘要
目的探讨数字化X线摄影尿路造影、螺旋CT(SCT)、磁共振成像(MRI+MRU)对上尿路结石与肿瘤所致梗阻的诊断价值。方法选取经超声检查,再行数字化X线摄影尿路造影诊断的76例上尿路结石与肿瘤病例,其中33例同时作了SCT检查,22例作了MRI+MRU检查。通过与手术、病理等进行对照,比较尿路造影与SCT、MRI+MRU对梗阻定位、定性及梗阻与扩张程度的鉴别,分析不同检查方法的诊断准确率。结果①数字化X线摄影尿路造影对梗阻定位、定性及梗阻与扩张程度诊断的准确率分别为:结石组,98·4%、96·8%、100%,肿瘤组,93%、93%、100%;SCT:结石组,95·7%、100%、95·7%,肿瘤组,90%、90%、80%;MRI+MRU:结石组,86·7%、60%、93·3%,肿瘤组,85·7%、71·4%、71·4%。②尿路造影、SCT与MRI+MRU定性诊断结石均有显著统计学差异(P<0·01),而在其他方面则无显著统计学差异(P>0·05)。结论上尿路结石,尿路造影结合泌尿系统平片(KUB)、超声为最主要的检查方法,SCT是最有价值的检查方法,MRI+MRU可作为补充检查手段;对于肿瘤,尿路造影为首选且有重要价值的检查方法,SCT可作出明确的定性及分期诊断,MRI+MRU可显示更多软组织病变信息。
Objective To approach the value of digital radiography urographic, SCT and MRI+MRU in diagnosing upper urinary tract calculi and tumour obstructive diseases. Methods Seventy-six patients were given ultrasound examination and were diagnosed as upper urinary tract calculi and tumour obstructive diseases by digital radiography urography. Of the 76 patients, 33 were examined by SCT and 22 by MRI+MRU. According to effects of surgery and pathological diagnosis, the accuracy of digital radiographic urography with SCT and MRI+MRU was compared for determining the obstructive location, nature and evaluating the degree of obstruction. Results Urography and MRI+MRU as well as SCTand MRI+MRU had obvious statistic difference on diagnosis of upper urinary tract calui (P<0.01), but no difference was showed on other aspects (P>0.05). Conclusion For upper urinary tract calculi, the mainly examinatorial means are digital radiography urography, KUB and ultrasound. SCT is the best method. MRI+MRU is regarded as a necessary supplement. For tumor, urography is the first elected very important means and can make clear-out diagnosis for the location, morphology, pathology range and cause of most tumors. SCT can make not only a explicit diagnosis for the nature and different stages but also a preoperative evaluation and provide a basis for selecting the operation way. MRI+MRU can manifest abundant information of soft tissue pathology to direct the surgery therapy.
出处
《山西医科大学学报》
CAS
2005年第3期365-369,共5页
Journal of Shanxi Medical University
关键词
结石
肿瘤
尿道梗阻
诊断
calculi
neoplasms
urethral obstruction
diagnosis
