摘要：
目的 探讨64层螺旋CT肾脏、尿路和血管(CTUA)同步成像技术的可行性及效果.方法 选择36例有泌尿系临床症状要求行CT尿路造影(CTU)检查的成年患者.排除碘剂过敏者;严重心、肝、肾功能不全者;多发性骨髓瘤;长期糖尿病、甲状腺功能亢进症等.患者经肘静脉留置管后,将300 mg I/mL碘海醇100 mL,分为40~60 mL和35~40 mL,间隔约25~45 min,分别以2~2.5 mL/s和3.5~4.0 mL/s速率团注射,末次注射后约20~30 s扫描尿路即得CTUA影像源,再延时约5 min扫描尿路即得CTU影像源.2组数据常规后处理,所有图像采用双盲法由2位有多年CTU诊断经验的医生独立阅片,分别对肾脏、尿路和肾血管图像质量进行评价,经统计学分析处理,判断CTUA检查方法的可行性及效果.结果 CTUA对肾脏实质、输尿管、膀胱及肾脏血管显示良好,显示率分别为:0.83、0.916、1、0.806,常规CT U相应显示率分别为:0、0.972、1、0.与常规CT U对比,在显示区分肾脏皮髓质及肾脏血管方面,CTUA与CTU差异明显,CTUA明显优于常规CTU,在显示输尿管及膀胱方面两者无明显差异,均显示良好.结论 CTUA技术优于常规CTU检查,常规剂量对比剂采用分2次团注1次扫描方法能同时显示肾脏、尿路及血管等信息.%Objective To investigate the feasibility and effect of synchronization imaging technology of 64-slice spiral CT on urography and angiography(CTUA).Methods 36 adult patients with urinary symptoms that apply for the conventional CTU were selected. Exclusion of iodine allergy,serious heart,liver and renal insufficiency,multiple myeloma,long-term diabetes,hyperthyroidism,etc.All patients were placed intravenous tube.100 mL iohexol(300 mg I/mL),divided into 40-60 mL and 35-40 mL,shall be injected respectively by interval about 25-45 min,and the corresponding injection rate was 2-2.5 mL/s and 3.5-4.0 mL/s.About 20-30 s after the second injection,scan urinary tract for a quick CTUA source image,then scan urinary tract again for a quick source image of CTU with 5 min delay.Two groups of data with reconstruction technique(including MPR,MIP,VR etc.)should be read and diagnosed independently and double-blinded by two doctors with many years'experience in CTU.They also need to evaluate the image quality of the kidneys,urinary tracts and renal vessels,and make a statistical analysis to judge whether the CTUA inspection technique was feasible and effective.Results CTUA was good at showing renal parenchyma,ureters,urinary bladder and renal vessels,and the display rate was respectively:0.83,0.916,1,0.806,by contrast,the conventional CTU was 0,0.972,1,0,accordingly.Compared with the conventional CTU,CTUA was obviously different from the CTU,especial in displaying the distinction between renal cortex and medulla,renal vessels,and CTUA was better than the conventional CTU.While in display of ureters and urinary bladder,they had no difference,both show good.Conclusion CTUA inspection technology is superior to the conventional CTU technique,and using a routine dose contrast medium with twice bolus injection and one scanning can provide information such as the kidneys,urinary tract and renal vessels.
