黄英 曾平 刘军 彭超 刘芸

摘要： 目的 探讨螺旋CT三维后处理成像在泌尿系梗阻性疾病的应用价值。方法 选取2019年3月至2021年2月，对187例有泌尿系系统疾病的患者行64排螺旋CT容积扫描及三维后处理成像，观察184例患者中阳性及阴性结果的差异。结果 在泌尿系三维后处理成像中，187例患者有181例阳性，3例未检出，其中泌尿系结石95例，泌尿系肿瘤34例，先天发育畸形所致泌尿系梗阻4例，外压性梗阻33例，泌尿系炎症15例。结论 三维后处理成像通过放射技师在工作站进行多种后处理重建方式，如MIP，MPR，CPR以及VR成像显示，加大了临床医生手术的视觉感，有利于为临床提供更准确、更直观的泌尿系全尿路显示。因此泌尿系三维后处理成像对分析泌尿系梗阻性疾病有很大的应用价值，每一位合格的方射技师务必熟练掌握螺旋CT三维重建的方法与技巧。

关键词：泌尿系梗阻性疾病;螺旋CT三维后处理成像;应用价值

Abstract： Objective To explore the application value of spiral CT three-dimensional post-processing imaging in urinary obstructive diseases. Methods from March 2019 to February 2021， 187 patients with urinary system diseases underwent 64 slice spiral CT volume scanning and three-dimensional post-processing imaging. The differences between positive and negative results in 184 patients were observed. Results in the three-dimensional postprocessing imaging of urinary system， 181 of 187 patients were positive and 3 were not detected， including 95 cases of urinary calculi， 34 cases of urinary tumors， 4 cases of urinary obstruction caused by congenital malformations， 33 cases of external pressure obstruction and 15 cases of urinary inflammation. Conclusion three-dimensional post-processing imaging can be performed by radiographers in various post-processing and reconstruction methods， such as MIP， MPR， CPR and VR imaging display， which increases the clinician's visual sense of surgery and is conducive to providing more accurate and intuitive display of the whole urinary tract for clinic. Therefore， three-dimensional post-processing imaging of urinary system has great application value for the analysis of urinary obstructive diseases. Every qualified square radiologist must master the methods and skills of three-dimensional reconstruction of spiral CT.

Key words： urinary obstructive diseases; Spiral CT three-dimensional post-processing imaging; Application value

泌尿系统各器官（肾脏、输尿管、膀胱、尿道）都可发生疾病，并波及整个系统，其主要表现在泌尿系统本身，如排尿改变、尿的改变、肿块、疼痛等，但亦可表现在其他方面，如高血压、水肿、贫血等。而泌尿系梗阻性疾病是临床较为常见的疾病，其泌尿系任一部位都可因管腔内外因素引发管腔堵塞从而导致梗阻性病变，一旦梗阻不能得到及时诊断及治疗，最终会导致患者出现肾积水，输尿管积水，严重者会导致肾功能障碍等。因此，早期的诊断治疗显得尤其重要，在以……