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目的探讨使用低张、利尿药物后多层螺旋CT(MSCT)非增强扫描曲面重组(CPR)对输尿管病变的诊断价值。资料与方法搜集2006年2月至2007年10月行尿路MSCT扫描患者124例,随机分成2组,即常规平扫(A组)52例,男32例,女20例,平均42.8岁;注射低张利尿药物后扫描(B组)72例,男性44例,女性28例,平均37.6岁。Toshiba Aqulion 16层螺旋CT机,1.0×16准直宽度,螺距1.0,一次屏气后从肾上极扫描至耻骨联合上缘。层厚/间隔1 mm/0.8 mm重组,在Vitra 2后处理工作站上以横断面为参考平面,在冠状面或矢状面上做输尿管CPR。分别统计各组的两侧输尿管显示优良率,SPLM 3.0统计软件处理,秩和检验,α=0.05,P<0.05。结果A、B组间按Wilcoxon等级资料比较,u=4.478(界值2.58),P<0.01,低张利尿后MSCT平扫后的输尿管CPR优良率明显高于未予低张利尿组。A组内患健侧比较,Kruskal-Wallis法:Hc=2.179,P<0.05(界值1.96),差异有统计学意义。B组内患健侧比较,Hc=7.441,P=0.0242>0.05(界值1.96),差异无统计学意义。结论使用低张利尿剂后进行MSCT扫描CPR的方法能清楚地显示全程输尿管,是一种简单省时、相对禁忌证少、患者无痛苦、可重复使用的较佳检查方法。
Objective To investigate the diagnostic value of non-enhanced scanning curved surface reconstruction (MSCT) of multi-slice spiral CT (MSCT) for ureteral lesions after using low-dose and diuretic drugs. Materials and Methods 124 patients with urinary tract MSCT scanned from February 2006 to October 2007 were randomly divided into 2 groups: group A, 52 cases, 32 males and 20 females, average 42.8 years; After the injection of low-diuretic drugs, 72 cases (group B) were scanned, including 44 males and 28 females, with an average of 37.6 years. The Toshiba Aqulion 16-slice CT scanner, with a 1.0 × 16 collimation width and a pitch of 1.0, was scanned from the upper kidney to the upper pubic symphysis after one breath-hold. Layer Thickness / Space 1 mm / 0.8 mm Reconstruction, with cross-section as reference plane on Vitra 2 postprocessing workstation, and ureter CPR on coronal plane or sagittal plane. Statistics of the ureter on both sides of each group showed good rate, SPLM 3.0 statistical software processing, rank sum test, α = 0.05, P <0.05. Results According to Wilcoxon grade data, the excellent and good rates of ureteric CPR after low-tension diuretic MSCT were significantly higher than those without low-diuretic group (u = 4.478, cutoff = 2.58). In group A, there was significant difference between the two groups (Kruskal-Wallis method: Hc = 2.179, P <0.05) (borderline 1.96). The difference was statistically significant. There was no significant difference between group B and group B (Hc = 7.441, P = 0.0242> 0.05). Conclusion The use of low-tension diuretic MSCT scanning CPR method can clearly show the entire ureter, is a simple time-saving, relatively less contraindications, patients with painless, reusable better inspection methods.