多层螺旋CT尿路成像在输尿管疾病中的临床应用-外科学专业论文.docxVIP

— — PAGE 1— 摘 要 多层螺旋 CT 尿路成像在输尿管疾病中 的临床应用 研究生：徐静 导师：张立东 副教授 摘 要 目的：评价并探讨多层螺旋CT尿路成像（CTU）影像学检查方法在输尿管疾病 中的临床应用价值。方法：收集在2008年6月—2009年9月期间新疆医科大学第一临 床医学院行多层螺旋CT尿路造影检查的61例输尿管疾病患者的CTU影像资料及其中 49例患者亦行的泌尿系平片加静脉尿路造影（KUB+IVU）检查影像学资料进行回顾 分析。分析CTU三维图像和KUB+IVU图像表现，分别做出影像诊断。以手术后病理 及治疗结果为金标准，比较在输尿管疾病的定位诊断和定性诊断中两种检查方法的 诊断符合率，从而详尽的评价CTU这一影像诊断方法的真实性、可靠性及收益。结 果：61例病例中，输尿管结石29例，输尿管肿瘤2例，输尿管结核9例，肾盂输尿管 狭窄5例，重复输尿管畸形2例，输尿管狭窄 6例，先天性巨输尿管1例，腹盆腔病变 致输尿管被累及或受压5例，先天性输尿管闭锁1例，输尿管囊肿1例。所有病例均经 手术或临床资料证实。CTU对于输尿管的显影明显优于KUB+IVU检查，其图像清楚 显示输尿管病变位置、大小、形态及输尿管梗阻扩张情况。其对输尿管疾病的定位 诊断符合率为100%，定性诊断符合率为93.44%。而KUB+IVU组分别为79.59%， 53.06%。CTU检查方法和KUB+IVU检查方法在诊断输尿管疾病之间的差异有统计学 意义。（P0.05）。结论：CTU检查与KUB+IVU检查方法相比能对输尿管疾病做出更 准确的定位、定性诊断，可为临床提供更多的信息，对输尿管结石、肿瘤及其他输 尿管疾病有着较高的临床应用价值。 关键词：输尿管疾病；多层螺旋 CT 尿路成像；应用价值 新疆医科大学医学硕士学位论文 Clinical Application of Multi-slice spiral CT urography in Ureters Diseases Postgraduate:Xu Jing Tutor: Zhang Lidong vice professor ABSTRACT Objective:To evaluate and assess the Clinical Application of mult-islice spiral CT urography(CTU) in ureters diseases. Methods: 61 cases of ureters diseases verified by pathology or diagnosed by clinical examination were collected in this study, and CTU and 40 KUB+IVU among them were retrospectively analyzed with the post-operative histopathological results and the result of treats(gold standard), to compare the diagnostic accordantly for ureters diseases between the methods of KUB + IVU and CTU, to evaluate CTU authenticities, reliability and yield. Results: Of 61 cases, there were 29 ureter stone,2 tumor of ureter, 9 tuberculosis of ureter,5 congenital stricture inureteropelvic junction, 2 pelviureteric duplication malformations, 6 stricture of ureter, 1 congenital megaureters, 5 ureter compression caused by external, 1 congenital ureter lock, 1 ureter cyst. All cases were confirmed by surgery or cilinical data. The images of CTU displayed the site, dimension and situation of ureters diseases clearly and provided high resolution images of the ureter tract. Contrasted KUB+