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目的探讨CT诊断脐尿管结石的临床价值。方法选择2001年1月—2011年6月诊治的脐尿管结石患者15例,使用Siemens Somatom Plus4、Marconi MX8000、GE Highspeed螺旋CT扫描机,其中5例同时行增强扫描,5例行多平面重组(multiplanar reconstru,MPR),6例行膀胱憩室切除术。结果 CT表现:13例结石发生于脐尿管与膀胱交界区;多发结石11例,单发结石4例;增强扫描4例呈轻度均匀强化,1例无明显强化;1例伴有膀胱结石(单发)、膀胱炎,CT能够清晰显示;5例行冠状、矢状及任意斜面重组,其中4例更加直观而清晰地显示结石位于脐尿管腔内及脐尿管走行,1例结石悬挂于膀胱前壁,2例同时可显示退化脐尿管痕迹。手术:6例行膀胱憩室切除术,术中见扩张的脐尿管与膀胱相通,3例膀胱前壁与脐尿管结合处增厚,2例向膀胱腔内呈火山口样突起。多发结石4例,单发结石2例。结论脐尿管结石的发生部位和影像表现典型,CT可作出明确诊断,指导临床治疗,避免不必要的手术。
Objective To investigate the clinical value of CT in the diagnosis of urethral calculi. Methods Fifteen patients with urethral calculus who were diagnosed and treated from January 2001 to June 2011 were diagnosed by using Siemens Somatom Plus4, Marconi MX8000 and GE Highspeed spiral CT scans. Five patients underwent simultaneous enhanced scan and five performed multiplanar reorganization (multiplanar reconstructive MPR), 6 cases of bladder diverticulum resection. Results CT findings: Thirteen stones occurred in the border of the urachus and the bladder; 11 cases had multiple stones and 4 cases had solitary stones; 4 cases showed mild and even enhancement in one case without enhancement; one case had bladder stones (Single), cystitis, CT can be clearly displayed; 5 cases of coronal, sagittal and arbitrary bevel reorganization, of which 4 more intuitive and clearly shows the stone in the uvula lumen and umbilical walking, a stone Suspended in the anterior wall of the bladder, 2 cases of degenerative urachlot can be displayed at the same time. Surgery: 6 cases of bladder diverticulum resection, see intraoperative expansion of the urachus connected with the bladder, 3 cases of anterior bladder wall and urachus junction thickening, 2 cases of bladder cavity was crater-like protrusions. Multiple stones in 4 cases, single stone in 2 cases. Conclusion The location of uracule calculi and the typical imaging manifestations, CT can make a clear diagnosis, guide clinical treatment, to avoid unnecessary surgery.