Abstract：Objective: To evaluate the value of delayed enhancement MSCTU scanning and image processing in the diagnosis of congenital urinary obstructive lesions in children. Methods: Delayed enhancement MSCTU scanning, image processing and ultrasonography were performed in 108 patients with congenital urinary obstruction lesions before operation, all cases were confirmed by operation. The cortical-phase images and the parenchymal-phase images were reconstructed with multiplanar reconstruction(MPR), the excretory-phase images were reconstructed with maximum intensity projection(MIP), curved planar reconstruction(CPR) and shade-surface displayment(SSD). The results of the two methods(MSCTU and ultrasonography) were then compared. Results: Ureteric pelvic junction obstruction(UPJO) of the left kidney is 76.19% in boys, and it is obviously higher than other urinary anomalies; the morbidity of hydro-duplex kidneys with hydro-duplex ureter is 84.00%, and most of the patients are girls. Renal function of the diseased kidneys are better in obstruction at ureteropelvic distalis, secretory function of the diseased kidneys exist in severe UPJO, and excretory function is disturbed; renal function of the diseased kidneys is the worst in severe renal hypoplsia and hydro-duplex kidneys. The accordance rate of MSCTU and ultrasonography with operation is 96.3%, 60.04%, respectively. MPR is a facile technique and it is for viewing function and construction of kidneys; CPR, MIP and SSD are for observing whole shape of collecting system, evaluating excretory function of kidneys, defining the site of obstruction and making qualitative diagnosis. Conclusion: Grasping best low-dose delayed enhancement MSCTU scanning time and adopting reasonable methods of image processing can diagnose congenital complex urinary obstruction lesions accurately in children, and it could be selected as one stop choice in diagnosing urinary lesions before operation.
2008, Vol. 19 
