摘要
目的：通过５１例ＫＵＢ、ＩＶＵ与ＣＴ平扫的对照研究，探讨ＩＶＵ有关输尿管阴性结石Ｘ线表现与ＣＴ相结合对输尿管结石的诊断价值。材料与方法：无选择性连续收集临床拟诊为泌尿系结石１６８例，除去肾结石２９例，膀胱结石４例，不作为本文研究对象，单就临床拟诊为输尿管结石１３５例进行分析研究，男９１例，女４４例，平均３８．６岁。临床均为急性胁腹部疼痛或伴血尿。经ＫＵＢ与ＩＶＵ明确诊断为结石者７６例，８例确认无异常征象。另５１例ＫＵＢ无异常，但ＩＶＵ有若干Ｘ线征象提示阴性结石存在的可能。然后针对拟诊输尿管阴性结石的感兴趣区作６ｃｍ长度的ＣＴ平扫。结果：２例因阴性结石染色明确诊断外，４９例经ＣＴ显示结石者４３例，检出率占８７．７％，其中２９例出现结石伴输尿管软组织轮缘征，占６７．４％，而这２９例结石直径平均在３．７ｍｍ以内。ＩＶＵ与阴性结石相关的征象有：一侧输尿管全程显影伴轻度扩张；输尿管某段突然萎陷变窄；输尿管某短段造影剂中断；输尿管间嵴增宽；截断征；梗阻性肾实质像；充盈缺损；结石染色。阴性结石占本组病例的２６．７％（４５／１６８），超过以往文献报告的１０％。结论：熟悉和掌握ＩＶＵ的Ｘ线征象结合ＣＴ平扫是诊断输尿管阴性结石?
Objective: To evaluate the soft tissue rim sign in CT in diagnosing and differentiating ureteral calculus.Materials and Methods:Plain CT scan was performed in 51 patients, who had normal plain abdomen films and were suspected of having radioluscent ureteral calculus in IVU, to clarify the existence of radioluscent ureteral calculus and the displaying rate of soft tissue rim sign.Results:Two cases showed dyed calculus. Forty three out of 49 cases demonstrated radioluscent calculus on CT scan (87.7%), of which 29 cases showed soft tissue rim sign (67.4%). The average diameter of the calculus was 3.7mm, with a CT value of 100～422HU. The maximum diameter of soft tissue rim sign shadow was 13.0mm (mean 6.4mm), with the CT value of 14～22HU, while the mean diameter of the calculus not showing soft tissue rim sign (n=[WT8.75BZ]14) was 5.8mm.Conclusion: Soft tissue rim sign is a reliable and valuable CT sign in diagnosing ureteral calculus, and is helpful in differentiating with phlebolith and calcification due to other nature.
出处
《临床放射学杂志》
CSCD
北大核心
1999年第2期94-97,共4页
Journal of Clinical Radiology
关键词
输尿管结石
阴性结石
静脉尿路造影
CT
Soft tissue rim sign Radioluscent ureteral calculus Tomography,X ray computed
