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目的:探讨CT平扫能否有助于对单侧输尿管梗阻患者急、慢性输尿管梗阻的鉴别。方法:回顾性分析2010年7月至2014年6月本院105例患者的中下腹+盆腔CT平扫资料,其中急性单侧输尿管梗阻、慢性单侧输尿管梗阻各35例,无输尿管梗阻35例作为对照组。分析比较急、慢性输尿管梗阻的继发CT平扫征象,测量上述病例双肾实质(上极、中份、下极)平扫CT值,比较其差异。结果:70例单侧急、慢性输尿管梗阻患者继发CT平扫征象有:肾周条带状改变、肾集合系统和/或输尿管积水扩张。肾周条带状改变在急性梗阻患者出现率较慢性梗阻患者高,前者为85.71%(30/35),后者为5.71%(2/35)。急性梗阻患者肾集合系统和/或输尿管积水扩张一般为无或轻-中度扩张,而慢性梗阻患者均出现不同程度的积水、扩张,以中度为著(25/35)。105例患者双肾实质平扫CT值测量结果经统计分析显示:急性输尿管梗阻侧肾实质密度明显低于慢性输尿管梗阻侧、同一病例对侧正常肾实质以及对照组肾实质密度(P<0.05),对照组及慢性输尿管梗阻患者双肾实质密度无明显差异(P>0.05)。结论:单侧急、慢性输尿管梗阻CT平扫继发征象有一定特点,联合CT平扫双肾实质密度差这个客观的、可测量参数,有助于区分急、慢性输尿管梗阻。
Objective: To investigate whether CT scan can help differentiate acute and chronic ureteral obstruction in patients with unilateral ureteral obstruction. Methods: The data of middle and lower abdomen + pelvic CT scan of 105 patients in our hospital from July 2010 to June 2014 were retrospectively analyzed. There were 35 cases of acute unilateral ureteral obstruction and chronic unilateral ureteral obstruction, 35 cases of ureteral obstruction As a control group. Analysis of acute and chronic secondary ureteral obstruction CT scan signs, measured in the above cases of renal parenchyma (upper, middle, lower pole) plain CT value, compared with the difference. Results: The signs of secondary CT scan in 70 patients with unilateral ureteral obstruction and chronic ureteral obstruction were: change of perirenal bands, expansion of renal collecting system and / or ureteral hydrops. Perinatal banding changes were more frequent in patients with acute obstruction than those with chronic obstruction, with 85.71% (30/35) in the former and 5.71% (2/35) in the latter. Patients with acute obstruction renal aggregation system and / or ureter fluid expansion is generally no or mild - moderate expansion, and patients with chronic obstruction have varying degrees of water, expansion, with moderate (25/35). The results of CT scan of 105 cases of bilateral renal parenchyma showed that the parenchymal density of renal tubules in acute ureteral obstruction was significantly lower than that of chronic ureteral obstruction, and the renal parenchymal density in contralateral normal renal parenchyma and control group in the same case (P <0.05) There was no significant difference in parenchymal density between control group and chronic ureteral obstruction (P> 0.05). Conclusion: The secondary signs of CT plain scan in unilateral acute and chronic ureteral obstruction have certain features. The objective and measurable parameters of CT differential scanning in renal tubal densities are helpful to differentiate acute and chronic ureteral obstruction.