经直肠超声与CT对输尿管下段病变的诊断价值

张韵华; 刘利民; 周盛; 陆清; 闻捷先

doi:10.12025/j.issn.1008-6358.2017.20160873

摘要: 目的：探讨经直肠超声（transrectal ultrasonography, TRUS）及CT对输尿管下段病变的诊断价值。方法：分析83例经手术和病理证实的输尿管下段病变患者病例资料，所有患者均行TRUS检查，68例患者接受CT检查。结果：输尿管结石34例，TRUS、CT的结石检出率分别为97.06%（33/34）、95.83%（23/24），P＝0.801；输尿管良性狭窄10例，TRUS及CT的诊断符合率分别为80.00%（8/10）及66.67%（4/6）；输尿管癌25例，TRUS及CT的诊断符合率分别为92.00%（23/25）及79.17%（19/24），P＝0.255；输尿管周围病变致输尿管狭窄或侵犯14例，TRUS及CT的定位诊断符合率分别为92.86%（13/14）及64.29%（9/14），P＝0.065；TRUS及CT定性诊断符合率分别为85.71%（12/14）及71.43%（10/14），P＝0.357。3例患者TRUS诊断不正确，但CT诊断正确；10例患者CT诊断不正确，但TRUS诊断正确。结论：TRUS及CT对输尿管下段病变均有较高的诊断价值，诊断效果相当，二者各有优势，可相互补充。

Abstract: Objective：To investigate the value of transrectal ultrasonography (TRUS) and CT in the diagnosis of distal ureteral diseases. Methods：The data of 83 cases of distal ureteral diseases proved by pathology or surgery were analyzed. All patients were examined by TRUS and 68 by CT. Results：For distal ureteral calculi (34 cases), the detection rates by TRUS and CT were 97.06% (33/34) and 95.83% (23/24) respectively (P＝0.801). For benign distal ureteral stricture (n=10), the diagnostic accuracy rates of TRUS and CT were 80.00% (8/10) and 66.67% (4/6), respectively. For ureteral cancer (25 cases), the diagnostic accuracy rates of TRUS and CT were 92.00% (23/25) and 79.17% (19/24), respectively (P＝0.255). For ureteral stricture or infiltration caused by periureteral lesions (14 cases), the localization diagnostic accuracy rates of TRUS and CT were 92.86% (13/14) and 64.29% (9/14), respectively (P＝0.065), and the qualitative diagnostic accuracy rates of TRUS and CT were 85.71% (12/14) and 71.43% (10/14), respectively (P＝0.357). In 3 cases，the diagnosis of TRUS was inaccurate but that of CT was accurate. In 10 cases, the diagnosis of CT was inaccurate but that of TRUS was accurate. Conclusions：TRUS and CT show similar high value in the diagnosis of distal ureteral diseases. Both have their own advantages and can complement each other.