摘要
目的评价螺旋CT三维重建在经皮肾镜取石术中的应用价值。方法对27例复杂性肾结石（17mm×31mm～28mm×57mm，平均27mm×38mm）患者行多层CT尿路造影，非增强CT扫描后，肾盂相期行造影剂增强扫描，数据分析后行三维重建。结果27例肾结石中鹿角状肾结石7例、肾下盏结石12例、肾盂结石5例、憩室结石3例。CT尿路造影可提供肾盂肾盏集合系统的清晰图像，并可发现结石，明确结石与肾盂肾盏集合系统关系，与常规图像比较，三维重建更有利于确定经皮肾穿刺部位。27例患者行经皮肾镜取石术，结石清除率为92％，无严重并发症发生。结论CT三维重建可准确预测肾结石数量、大小及部位，确定经皮肾穿刺位置，降低手术并发症，应作为复杂性肾结石经皮肾穿刺取石术前的常规影像学定位方法。
Objective To assess the utility of spiral computed tomography （CT） with three-dimensional（3D） reconstruction for preoperative planning of percutaneous nephrolithotomy（PCNL） in patients with renal calculi. Methods Twenty-seven patients with complicated renal calculi（17 mm× 31 mm～ 28 mm×57 mm, mean 27 mm×38 mm） underwent multislice computed tomographic urogra phy（CTU）. After unenhanced CT of the abdomen, a high-resolution contrast-enhanced scan was taken through the kidneys in the pyelographic phase. Data were analysed by using multiplanar reconstruction and three-dimensional reformatting. Results In 27 3DCT there were 7 staghorn, 12 low in fundihular, 5 renal pelvic and 3 diverticular calculi; CTU provided a good map of the pelviealyeeal system （PCS）. CTU detected stones in all patients and accurately located their relation to the PCS. With reconstructed images, subjectively the 3D imaging provided an advantage over conventional imaging in optimizing nephrostomy placement. ALL patients had PCNL, the stone-free rate was 92%, no severe complications were recorded. Conclusions CT with 3D reconstruction enables an accurate and confident, reproducible prediction of the number, size and site of stones in pelvicalyceal anatomy, optimal site（s） for placing the percutaneous track, and potential hazards when placing the track, 3D-MSCT should become an imaging method for planning PCNL in patients with complicated renal calculi.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2007年第6期379-381,共3页
Chinese Journal of Urology
基金
广东省自然科学基金资助项目（020729）
