MSCT后尿道排泄造影术对前列腺增生症致膀胱出口梗阻的诊断价值

发布时间：2018-09-09 11:32

【摘要】：目的:探讨多层螺旋CT后尿道排泄造影成像术(MSCT-VUPU)对良性前列腺增生症(BPH)继发膀胱出口梗阻(BOO)的诊断价值。方法:选取经临床诊断为BPH继发BOO的患者28例,全部患者行MSCT-VUPU扫描。另选取无排尿困难、并经临床检查无前列腺增生的10例受检者作为对照组,同期接受MSCT-VUPU扫描。扫描数据经工作站进行多平面重组(MPR)、最大密度投影(MIP)、容积再现(VR)等后处理,由两名影像医师共同对全部病例的MSCTVUPU影像学改变做出诊断。结果:28例BPH患者均有不同程度后尿道狭窄。28例中,表现为不同程度膀胱小梁化改变21例,膀胱形态改变9例,膀胱壁增厚及粘膜强化7例。膀胱形态改变及膀胱小梁化程度均与前列腺增生症分期呈正相关(r=0.524、0.514,P0.05),膀胱粘膜增厚强化与小梁化程度呈正相关(r=0.485,P0.05)。后尿道前列腺部上下径与前列腺后叶前后径呈正相关(r=0.729,P0.0001)。结论:MSCT-VUPU技术使BPH患者在排尿过程中完成扫描并获得到膀胱及尿道全程显影;具有无创、清晰及可以任意方位重组观察等优点,能客观判断BOO引起的后尿道及膀胱的形态并评估膀胱功能。
[Abstract]:Objective: to evaluate the diagnostic value of multislice spiral CT posterior urethral excretion angiography (MSCT-VUPU) in the diagnosis of bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH). Methods: 28 patients with BOO secondary to BPH were selected, all of whom underwent MSCT-VUPU scan. Ten patients with no dysuria and no benign prostatic hyperplasia were selected as control group. MSCT-VUPU scan was performed at the same time. The scanning data were processed by multiplanar recombination (MPR), maximum density projection (MIP), volume reconstruction (VR) and so on. The two radiographs made the diagnosis of MSCTVUPU imaging changes in all cases together. Results among 28 cases with BPH, 21 cases had different degree of posterior urethral stricture, 9 cases had bladder morphology, 7 cases had thickening of bladder wall and 7 cases had mucosal enhancement. The changes of bladder morphology and the degree of bladder trabecularization were positively correlated with the stage of benign prostatic hyperplasia (r = 0.524), and the thickening of bladder mucosa was positively correlated with the degree of trabecularization (P 0.05). There was a positive correlation between the superior and inferior diameter of the posterior urethral prostate and the anteroposterior diameter of the posterior lobe of the prostate (r = 0.729, P 0.0001). ConclusionMSCT-VUPU technique enables BPH patients to complete the scanning during urination and obtain the whole process of bladder and urethra development, which has the advantages of noninvasive, clear, and can be observed in any direction. Objective to judge the shape of posterior urethra and bladder caused by BOO and evaluate bladder function.
【作者单位】：同济大学附属杨浦医院放射科;同济大学附属杨浦医院泌尿科;
【分类号】：R699;R816.7

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