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目的探讨16层螺旋CT曲面重建(curved planar reformation,CPR)技术在输尿管中下段结石诊断中的临床应用。方法收集2008年11月至2009年11月在渝北区人民医院就诊的31例临床高度怀疑输尿管结石病例,其中男性19例,女性12例,平均年龄41.6(17～81)岁。回顾性分析患者的16层螺旋CT腹部扫描数据,在图像工作站将数据行曲面重建(curved planar reformation,CPR)后处理并结合原始横断面图像进行综合分析。结果 31例共显示输尿管中下段结石46枚,其中25枚位于输尿管末端膀胱入口处,21枚位于中下段其余部位。多发结石者11例,单发结石者20例。所有病例均经手术或输尿管镜检查证实。结论 CPR能清晰地显示出输尿管全程及结石的位置、数目及其形态,在与输尿管中下段走行附近的血管壁钙化和静脉石的鉴别诊断方面有独特的优势。
Objective To explore the clinical application of 16-slice spiral CT reconstruction (CPR) in the diagnosis of middle and lower ureteral calculi. Methods A total of 31 clinically suspected cases of ureteral calculi in Yubei District People’s Hospital from November 2008 to November 2009 were collected, including 19 males and 12 females, with an average age of 41.6 (17-81) years. A retrospective analysis of the 16-slice spiral CT scan of the abdomen of a patient was made and the post-processing of the data was performed with curved planar reformation (CPR) at the image workstation and analyzed in combination with the original cross-sectional images. Results A total of 46 cases of ureteral calculi in the middle and lower ureter were found in 31 cases, of which 25 were located at the entrance of the ureter at the end of the bladder and 21 in the rest of the middle and lower segments. Multiple stones in 11 cases, single stones in 20 cases. All cases were confirmed by surgery or ureteroscopy. Conclusions CPR can clearly show the location, number and shape of the entire ureter and stones, and has unique advantages in the differential diagnosis of vascular calcification and vein stone near the middle and lower ureter.