| Objective: Upper urinary tract obstruction is a common and frequently-occurring disease in the urinary system, because its various clinical manifestations, disease complex, more acute onset of renal and systemic damage is more serious, acute and severe cases, even can be a threat to the life of the patient, Therefore, early detection of the disease, early diagnosis and early treatment is very important. However, the etiology of the disease is much more and lack of specificity of clinical symptoms, it is difficult for clinicians to make rapid and effective diagnosis for the disease, To alleviate the suffering of the patients in a timely manner, but also reduce the patient's economic burden, this paper aims to analyze the practicality, accuracy and profitability that the B super, X ray (KUB, IVU, RU), MSCT as a imaging methods diagnose the urinary tract obstruction that caused by a variety of common causes, then make a comprehensive evaluation to its application, so I can offer a range of effective, convenient, safe and non-invasive inspection program that can help clinician make right , rapid diagnosis to upper urinary tract obstruction, thus could secure valuable time for early detection of disease , early diagnosis and early treatment.Methods: collect outpatients and inpatients on a total of 195 cases of patients with urinary tract obstruction from February 2009 to February 2011 in our hospital , 106 patients were male, 89 were female cases, aged 4-81 years of age, duration of 8h-10 years The main symptoms and signs are pain, mass, dysuria, and urine output, urine color change or the emergence of the infection symptoms. 92 patients with lesions in the left and right in 85 cases, bilateral in 18 cases, of which a total of 188 cases examined by the B superultrasound in patients , 52 patients examined by KUB in patients, and 137 cases examined by IVU in patients, 79 cases examined by RU in Patients, and patients with MSCT examination were 129 cases, some patients with the need of patients 's condition examined by joint inspection in many ways. For patients that failed to clear diagnose the cause scaned by enhanced MSCT in the case of no clear contraindications, all scanning images would transmitted to the workstation for reconstructing with the two-dimension, three-dimension after thinning .After all patients following treatment of pathological or clinical findings, according to etiology can be divided into four groups:①stone group, including in the various parts of the upper urinary tract stones and various components's stones;②tumor group, including neoplastic lesions that inside the lumen or outside the urinary tract, and abdominal cavity, pelvic diseases that oppress the urinary tract ;③inflammation group, including a variety of specific and non-specific inflammation that occurred in urinary tract , such as tuberculosis and other upper urinary tract obstruction caused by diseases;④congenital urinary tract malformation groups, including the various parts of the upper urinary tract obstruction caused by congenital malformation lesions. Finally, comparing with the various imaging methods on the detection rate of location and qualitative diagnostic accuracy for the urinary tract obstruction, , and then assessed the authenticity,reliability,and profitability of various diagnostic imaging methods.Results: 195 patients were detected in 80 patients with gallstone group, 45 patients with tumor group, 30 patients with inflammatory group, 40 patients with congenital malformation group. B super, IVU, RU, MSCT ,its relevance ratio of upper urinary tract obstruction were 86.7%, 86.1% and 74.6%, 86.8%, four imaging method of detection are no difference by theχ2 test ; of the urinary road obstruction level of positioning accuracy were 56.9%, 89.1%, 78.5%, 97.7%, theχ2 test showed the highest accuracy of the positioning is MSCT, the lowest is B super , MSCT is better than IVU, significantly higher than RU and B super, The difference was significant, with statistical significance (p <0.007); on the qualitative accuracy of urinary tract obstruction:①stone groups of patients: B Super, KUB, IVU, RU, MSCT and the method of the B super combined KUB to the patients's accuracy of diagnosis were 62.5%, 57.8%, 68.4%, 70.8% 97.2%, 89.7%, the statistical test showed, B super, KUB, IVU, RU were no difference between the accuracy rate, but the accuracy of MSCT was significantly higher than that of B super, KUB, IVU, and RU, the result was statistically significant (p <0.003), while the accuracy of the examination that B super combined KUB is higher than the B super or KUB, and the difference was statistically significant;②cancer group of patients: The B super, IVU, RU, MSCT by means of the four check the accuracy of qualitative diagnosis of the disease were 46.7%, 32.4%, 43.5% , 87.1% .found by comparing the means of MSCT compared with the another three methods have greater advantages, and the differences were statistically significant, while the another three check means were no difference in accuracy each other③Inflammation Group: B super, IVU, RU, MSCT ,examination revealed a variety of inspection methods the accuracy of diagnosis were 30%, 36.7%, 36.8%, 86.7%, four examination methods were significant differences each other, in which the accuracy of MSCT was significantly higher than B super, IVU, RU, while the B super, IVU, RU accuracy between each other were no significant difference ;④congenital. malformations group: The diagnostic accuracy of the B Super, IVU, RU, MSCT were separately 45.5%, 85%, 53.%, 95.8%, afterχ2 test showed MSCT, IVU diagnostic accuracy was significantly higher than that of B super, and accuracy the two each other was no significant differenceConclusions:1 Image methods on the diagnosis of upper urinary tract obstruction can play a decisive role, with a high clinical value, the accuracy rate can meet to the needs of a variety of clinical, so imaging methods should be the highest priority and most important examination methods while diagnosing urinary tract obstruction;2 MSCT is the most valuable imaging method in diagnosing upper urinary tract obstruction ;3 B super has the high positive detection rate of disease in diagnosing upper urinary tract obstruction, and non-invasive, economic, simple, convenient, can be used as a preferred way of checking in diagnosing upper urinary tract obstructive diseases of various;4 To be suspected patients that have obstruction of various types of stones on clinical should be inspected by the B super and KUB joint inspection at first.and supplemented by targeted as a necessary complement with MSCT TLC inspection program;5 To the suspected causes of upper urinary tract obstruction caused by cancer and inflammatory group , should use B super and MSCT joint inspection program, if necessary, for no apparent case of contraindications ,can plus enhanced MSCT scan, the vast majority of upper urinary tract obstruction can be achieved accurately and quickly to make clear the purpose of diagnosis;6 To suspected patients that have urinary tract obstruction caused by congenital malformations, with B super and IVU joint inspection should be as the preferred, if necessary, supplemented by RU and MSCT scans as a supplement to screening programs.
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