Clinical Application Of The Different Scanning Phases Film With Image Post-processing Techniques Of The MSCTU In The Diagnosis Of Congenital Malformation In Urinary System

Objective: To analyze the best diagnostic scanning and image processing methods of multi-slice spiral CT (MSCT) in the detection of urinary tract congenital malformations . Methods: From June 2008 to December 2009 ,263 patients with 64-slice spiral CT scanning were collected in Tongji Hospital .263 cases were sorted as two category: the ureter and renal collecting duct system malformations ;the kindey malformations .Those patients were reviewed retrospectively: Diagnostic accuracy of urinary malformation were calculated on the image of axial and MPR, Curve, MIP, VR by MSCT unenhangced scanning, enhangced cortical phase scanning, enhangced parenchymal phase scanning and enhangced excretory phase scanning.Results: 104 patients with kidney abnormalities ,by observingthe MSCT unhangced scan axial and MPR, Curve film , enhangced cortical phase scanning, enhangced parenchymal phase scanning , enhangced excretory phase scanning and MPR,MIP,VR film, The diagnostic accuracy were: renal dysplasia(72.73%,81.82%,81.82%,72.73%),renal hypoplasia(83.33%,91.67%,95.83%,100%),solitary kidney(100%,100%,100%,100%),ectopic kidney(76.92%,,100%,100%,100%), horseshoe kidney(100%,100%,100%,100%),misplaced renal lobe(0%,100%)。MSCT plain film also can show the stones of the urinary tract。The enhangced corticomedullary phase film may at the same time show the thickness of the renal parenchyma and the degree of enhancement, renal artery and its variation, with or without renal artery local stenosis or expansion.159 patients with congenial malfortions of the collecting system and ureter,by observing the MSCT unhangced scan axial and MPR, Curve film , enhangced cortical phase scanning, enhangced parenchymal phase scanning , enhangced excretory phase scanning and MPR,MIP,VR film, The diagnostic accuracy were: ureteropelvic junction obstruction(63.49%,79.37%,87.30%,95.24% ) ,renal pelviureteral duplication ( 17.54%,29.82%,29.82%,92.98%),ureteral cyst(73.33%,73.33%,73.33%,100%),extrarenal pelvis(66.67%,66.67%,66.67%,83.33%).At the same time,MSCT plain film can show the stones of the urinary tract。The MPR film of enhangced excretory phase shows ectopic ureter paragraph by paragraph, ureteral cyst, the MIP and VR images can visually show urinary system three-dimensional picture.Conclusion: The MSCT plain film in the diagnosis of congenital malformation of the urinary system is of limited values, while the MSCTU film with image post-processing techniques in the diagnosis of congenital malformations of urinary system diseases has their unique advantages,which can be used as preferred method in examination.