- 泌尿系统多层螺旋CT诊断学
- 王其军 韩志江 刘红光
- 2750字
- 2020-08-28 10:29:07
第六节 泌尿系统正常多层螺旋CT表现
一、CT平扫断面图像
(一)横断位图像
见图1-6-1~图1-6-14。
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-1_1114.jpg?sign=1739480303-VlUeSwbgU3plfKcN3OnGUEWRHkl0Uf4V-0-8b164a5e4c044ff26913e8c1c4d8d8b0)
图1-6-1 经右肾上腺层面
1.右肾上极;2.右肾上腺;3.右侧膈脚;4.肝脏;
5.门静脉;6.胃窦;7.胰腺;8.降主动脉;9.脾脏
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-2_1117.jpg?sign=1739480303-QjBEJESkEHaIpPEPDZY8nFxaKkhoiyzP-0-706a3e8e81ff7e3a597d0eb8333db123)
图1-6-2 经胰体部层面
1.右肾;2.肝脏;3.胃窦;4.十二指肠降段;
5.门静脉;6.下腔静脉;7.右侧膈脚;8.胰腺;
9.降主动脉;10.左肾上腺;11.左侧膈脚;
12.左肾上极;13.脾静脉;14.脾脏
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-3_1120.jpg?sign=1739480303-FKa2x6EY1DZSvuBt8n9dw2nzvYmUOjX7-0-554959522f35e8a87762de8c86a0ea91)
图1-6-3 经右肾门层面
1.右肾;2.右肾盂;3.右肾静脉;4.下腔静脉;
5.升结肠;6.十二指肠降段;7.胃;8.胰腺;
9.右侧膈脚;10.降主动脉;11.左肾上腺;
12.左肾;13.左侧膈脚;14.小肠;15.胰尾;
16.降结肠;17.脾脏
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-4_1123.jpg?sign=1739480303-vg3AOAPtTVd7iHI6brOpxhto4xJL3xKl-0-7d7b9a06259a51abfffcece97a69330c)
图1-6-4 经左肾门层面
1.右肾;2.右肾盂;3.升结肠;4.下腔静脉;
5.十二指肠降段;6.胃;7.降主动脉;8.左肾静脉;
9.左肾动脉;10.小肠;11.左肾;12.左肾窦;
13.降结肠
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-5_1146.jpg?sign=1739480303-la5by8SNBzSuyhkoL5el6GhuSOQ9GnaM-0-a286effd7a183bde42f44688e0272636)
图1-6-5 经左肾门下层面
1.右肾;2.右肾盏;3.升结肠;4.十二指肠降段;
5.胃;6.下腔静脉;7.肠系膜上静脉;
8.肠系膜上动脉;9.降主动脉;10.空肠;
11.左卵巢静脉;12.左肾静脉分支;13.左输尿管;
14.右输尿管;15.左肾窦;16.左肾;17.降结肠
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-6_1149.jpg?sign=1739480303-w4x0BK4OsCrl9qz7aXOOCDjAPDYmxsc7-0-74f75dbbb057ab6436c974c4454c2a82)
图1-6-6 经十二指肠水平段层面
1.右肾;2.升结肠;3.横结肠;4.胃;
5.十二指肠水平段;6.右卵巢静脉;7.右输尿管;
8.下腔静脉;9.肠系膜上血管;10.降主动脉;
11.左卵巢静脉;12.左输尿管;13.左肾;14.小肠;
15.降结肠
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-7_1152.jpg?sign=1739480303-jRcif8PkQrlw3ij5njSPZeTWb9Pci7TS-0-f3471401ff625926acdf8c0092925ca7)
图1-6-7 经右肾下极层面
1.右肾;2.升结肠;3.横结肠;4.右卵巢静脉;
5.右输尿管;6.下腔静脉;7.十二指肠水平段;
8.降主动脉;9.左卵巢静脉;10.左输尿管;
11.左肾;12.降结肠
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-8_1155.jpg?sign=1739480303-wmuNxYckoup9nKEX20LgnT7jNT1P5BfI-0-49f94a29c80dc6e1501cf64fae490504)
图1-6-8 经十二指肠水平段下部层面
1.右肾;2.升结肠;3.横结肠;4.右卵巢静脉;
5.右输尿管;6.下腔静脉;7.十二指肠水平段;
8.降主动脉;9.左卵巢静脉;10.左输尿管;
11.左肾;12.小肠;13.降结肠
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-9_1180.jpg?sign=1739480303-AbhB0yvlDeR8OkBmR6dRRGiaDZ0idHf4-0-99a85567b7b877eff78fc7f78206823c)
图1-6-9 经髂血管分叉层面
1.升结肠;2.右卵巢静脉;3.右输尿管;
4.右髂总静脉;5.右髂总动脉;6.左髂总静脉;
7.左髂总动脉;8.左输尿管;9.左卵巢静脉;
10.小肠;11.降结肠
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-10_1183.jpg?sign=1739480303-HXQ1uH0xphMFUbdGHi7dhA19RZhECg5E-0-722ab47fcbcf21cc248926b3ae6e6a62)
图1-6-10 经子宫体中部层面
1.右髂外血管;2.右髂内血管;3.右输尿管;
4.直肠;5.子宫;6.膀胱;7.左子宫圆韧带;
8.左髂外血管;9.左输尿管;10.左髂内血管;
11.乙状结肠;12.回肠末端
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-11_1186.jpg?sign=1739480303-BajKkphfwmyjHRzLJbXJ9ILtoEKueEHS-0-641a0a85fc9451dd80eaa2d56a94a693)
图1-6-11 经子宫体下部层面
1.右髂外血管;2.膀胱;3.右输尿管、宫旁血管丛;
4.子宫;5.直肠;6.左输尿管、宫旁血管丛;
7.左髂外血管
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-12_1189.jpg?sign=1739480303-CNt83MzJVnWgjK7NJZSXXqHF1AgX3B8e-0-981bf0797acd0458592278931d341574)
图1-6-12 经子宫颈部层面
1.右髂外血管;2.膀胱;3.右输尿管远端;
4.宫旁血管丛;5.左输尿管远端;6.子宫壁;
7.宫颈管腔;8.直肠;9.左髂外血管
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-13_1212.jpg?sign=1739480303-dLmms7or1rvAKj1F1xmamn52acnteDdh-0-e4a5cf6dabb054afdb8acdee55a5e26c)
图1-6-13 经子宫颈下部层面
1.右髂外血管;2.膀胱;3.宫旁血管丛;4.子宫颈;
5.直肠;6.肛提肌;7.左髂外血管
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-14_1215.jpg?sign=1739480303-vFEZkbfChLEvynfk9SsOWUPHBNg3Mlk0-0-d0947ead0e846b6759530bf193255083)
图1-6-14 经耻骨联合层面
1.右髂外血管;2.闭孔;3.闭孔内肌;4.膀胱;
5.子宫颈、阴道穹窿;6.直肠下端;7.肛提肌;
8.左髂外血管
(二)冠状位图像
见图1-6-15、图1-6-16。
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-15_1219.jpg?sign=1739480303-HP8YAua8E44WPxruvefs9UkIRCXNGLZr-0-b8c83749fc1ee933752c06306288f14b)
图1-6-15 腹膜后椎体前部层面冠状CT图像
1.升结肠;2.右侧肾周间隙;3.右肾;
4.右侧腰大肌;5.下腔静脉;6.降主动脉;
7.左肾;8.左侧肾周间隙;9.降结肠;
10.左侧腰大肌;11.乙状结肠;12.膀胱顶壁;
13.右输尿管;14.左输尿管
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-16_1222.jpg?sign=1739480303-l5H3IlVKM7jvPQl5M9kjZESV0UCbdiM7-0-1738a5d2d5a56794eabf03d42f01fc64)
图1-6-16 腹膜后椎体层面冠状CT图像
1.右侧肾周间隙;2.右肾;3.左肾;4.降结肠;
5.左侧肾上腺;6.右侧肾上腺;7.肝脏;8.脾脏;
9.左肾门;10.右肾窦;11.乙状结肠;12.膀胱顶壁
(三)矢状位图像
见图1-6-17~图1-6-21。
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-17_1249.jpg?sign=1739480303-39v76t2TYX80RF5HqbzW2Q1ny0gk1IUb-0-20fc7861310548ace7f36e8aaa47dfe6)
图1-6-17 腹膜后右外侧层面矢状位CT图像
1.右侧肾后间隙;2.右侧肾后筋膜;
3.右侧肾周间隙;4.肝脏
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-18_1252.jpg?sign=1739480303-BIZ4l97dftO1EIAPbp1qh28s8b69uctC-0-8829582fb8f53953634b30df51a5c54d)
图1-6-18 腹膜后右肾中部层面矢状位CT图像
1.右侧肾后间隙;2.右侧肾后筋膜;3.右侧肾周间隙;
4.右肾;5.右侧肾前筋膜;6.肝脏;7.胆囊
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-19_1255.jpg?sign=1739480303-SvTG09heUZVN2NmxhLxqGK5M8yXZtFkj-0-ddcd7ffa75e632f8bbf9c20cf43f5a36)
图1-6-19 腹膜后左肾内侧层面矢状位CT图像
1.左侧肾后间隙;2.左侧肾后筋膜;3.左侧肾周间隙;
4.左肾;5.左肾前筋膜;6.胃
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-20_1258.jpg?sign=1739480303-Q7rhj8WdxnOSh6M1npNWCI1rq9jEDhXQ-0-86773e3a1e7f2fd4eb56bb01e3fd2bbb)
图1-6-20 腹膜后左肾中部层面矢状位CT图像
1.左侧肾周间隙;2.左肾;3.左肾后筋膜;
4.左侧肾后间隙;5.左肾前筋膜;6.脾脏;
7.胃;8.结肠
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-21_1281.jpg?sign=1739480303-14lml1bt77C04Ys4R4Ni5r9sp3PY5eWI-0-29fb0c02779749061d4b318f60564007)
图1-6-21 腹膜后左肾外侧层面矢状位CT图像
1.左侧肾后间隙;2.左肾后筋膜;3.左肾;
4.左侧肾周间隙;5.脾脏 ;6.胃;7.结肠
二、CT增强断面图像
见图1-6-22~图1-6-30。
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-22_1286.jpg?sign=1739480303-1Ucg8tQP2X4C4AETxAEry69H16py5ez8-0-49d41418f97c8923669f7ed30c095850)
图1-6-22 经肠系膜上动脉起始层面(动脉期)
1.肾皮质;2.肾髓质;3.腹主动脉;
4.肠系膜上动脉;5.左肾上腺;6.左肾窦;
7.脾脏;8.下腔静脉
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-23_1289.jpg?sign=1739480303-1Rp7e1bjyFX3PAIDgDAhzREnRflwmfRd-0-8993945547dacd07da2d010107033027)
图1-6-23 经肾门层面(动脉期)
1.肾皮质;2.肾髓质;3.肾静脉;4.肾动脉及分支;
5.腹主动脉;6.肠系膜上动脉;7.下腔静脉;
8.肠系膜上静脉
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-24_1314.jpg?sign=1739480303-CItAxBnQi7EX75y6p4Z2EIGx0UUgTshN-0-c4380edde7c1dafeb244a2a5649d639f)
图1-6-24 经肾门下方层面(动脉期)
1.肾皮质;2.肾髓质;3.肾窦;4.腹主动脉;
5.肠系膜上动脉;6.输尿管;7.下腔静脉;
8.肠系膜上静脉
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-25_1317.jpg?sign=1739480303-CdujBo9gL6J7fsN0tyrUrt6KHPUH21bf-0-98165e4d21c3f16a09f7673cae44a6db)
图1-6-25 经肠系膜上动脉起始层面(皮髓质期)
1.肾实质;2.腹主动脉;3.肠系膜上动脉;
4.下腔静脉;5.左肾窦;6.脾脏;7.左肾上腺
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-26_1320.jpg?sign=1739480303-YoOpnNKxttRwGKuLtjoNYPOb5KT5ns8k-0-3abdfbbafb35b1215d67d9198b4e34b5)
图1-6-26 经肾门层面(皮髓质期)
1.肾实质;2.肾窦;3.肾动脉及分支;4.腹主动脉;
5.下腔静脉;6.肾静脉;7.肠系膜上静脉;
8.肠系膜上动脉
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-27_1323.jpg?sign=1739480303-rUT8mv3rU9jbVy61dlToWnnqBhKHHPlY-0-85a3e0d5f09c3784166a630570f86da0)
图1-6-27 经肾门下方层面(皮髓质期)
1.肾实质;2.肾窦;3.输尿管;4.下腔静脉;
5.腹主动脉;6.肠系膜上静脉;7.肠系膜上静脉
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-28_1348.jpg?sign=1739480303-Y5jE6lBLdN71jLIwb1Ejv7H63D1X3icc-0-3bf738752bb8ee6b569719ac4380f0d7)
图1-6-28 经肠系膜上动脉起始层面(排泄期)
1.肾实质;2.腹主动脉;3.肾小盏;4.肠系膜上动脉;
5.下腔静脉;6.脾脏;7.左肾上腺
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-29_1351.jpg?sign=1739480303-O2eycsQWjTJYTJDlKfR26r0Xl664kdyT-0-30e4442996e080b6351f14e615f2497d)
图1-6-29 经肾门层面(排泄期)
1.肾实质;2.肾盏;3.肾静脉;4.肾动脉及分支;
5.腹主动脉;6.下腔静脉;7.肠系膜上静脉;
8.肠系膜上动脉
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-30_1354.jpg?sign=1739480303-TgpUmzXaagfnAcT6FBeb7jGrVGHZfbrl-0-d031154bca5aaa342dffe24c956a57e5)
图1-6-30 经肾门下方层面(排泄期)
1.肾实质;2.肾窦;3.输尿管;4.下腔静脉;
5.腹主动脉;6.肠系膜上静脉;7.肠系膜上静脉
三、肾动脉CT血管造影图像
见图1-6-31。
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-31_1380.jpg?sign=1739480303-PMjBoFww20CIT59v1eyywyKTMWoDnEo1-0-d242ce02cd20fa97cff1b942b683b54a)
图1-6-31 肾动脉CT血管造影
A.VR像;B.CPR像;C.MIP;D.VE
1.右肾动脉及分支;2.左肾动脉及分支;3.肝总动脉及分支;
4.脾动脉;5.肠系膜上动脉;6.腹主动脉
四、泌尿系统CT尿路造影图像
见图1-6-32。
![](https://epubservercos.yuewen.com/367379/15859860104888206/epubprivate/OEBPS/Images/P1-6-32_1413.jpg?sign=1739480303-rOyjcVCOp1jmcFoXH3Sqtbf9T591tbbF-0-941698a930b7f786d07140a27116d3c6)
图1-6-32 泌尿系CT尿路造影
A.VR像;B.MIP;C.CPR像
1.肾脏;2.肾盂;3.输尿管;4.膀胱;5.肾小盏;6.肾大盏
(石智红 王其军)
参考文献
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