Sonovue排泄性超声尿路造影与X线膀胱尿路造影的比较研究  

Voiding urosonography with SonoVue and fluoroscopic voiding cystourethrography in evaluation of vesicoureteral reflux: a comparative study

作　　者：邓劲松[1] 周路遥[2,3] 曾斯慧 张春丽[1] 曾广绥[1] 王洁[1] 陈庆康[1] 

机构地区：[1]武警广东省总队医院超声影像科,广东广州510507 [2]中山大学附属第一医院超声科 [3]中山大学超声诊断与介入超声研究所,广东广州510080 [4]广州市妇女儿童医疗中心放射科,广东广州510623

出　　处：《南方医科大学学报》2013年第10期1467-1470,共4页Journal of Southern Medical University

基　　金：国家自然科学青年基金(81301238)~~

摘　　要：目的探讨Sonovue排泄性尿路超声造影(VUS)评估膀胱输尿管返流(VUR)的价值。方法纳入36例[共72个肾盂-输尿管单位(Pyelo-Ureter Units,PUUs)]临床疑为膀胱输尿管返流且同时进行了VUS和排泄性X线膀胱尿路造影(VCUG)的儿童病人。比较VUS和VCUG发现VUR的敏感性和一致性。根据返流分级标准比较两者判断返流分级的一致性。结果 72个PPUs,VUS发现26个PUUs(36.1%,26/72),而VCUG发现21个PUUs(29.2%)存在返流,两者对返流检出率的差异无统计学意义(P=0.347)。65个PUUs(90.3%,65/72)的结果在两种方法完全一样(McNemar检验,Kappa值=0.843),表明两者的一致性较好。另外,VUS经会阴部观察还显示了2个病例的后尿道瓣膜。结论 Sonovue介导的VUS在检测和分级膀胱输尿管反流上不差于甚至优于VCUG,且更安全,应该作为膀胱输尿管返流的首选筛查和随访工具。另外,VUS经会阴部观察对评估后尿道病变也有一定帮助。Objective To assess the value of voiding urosonography （VUS） with SonoVue in evaluation of vesicoureteral reflux. Methods Thirty-six pediatric patients （72 pyeloureter units [PUUs]） suspected of vesicoureteral reflux underwent both VUS and fluoroscopic voiding cystourethrography （VCUG）. The sensitivity of VUS and VCUG and their consistency in detecting vesicoureteral reflux as well as in grading vesicoureteral reflux were compared. Results Vesicoureteral reflux was detected in 26 of the 72 PUUs （36.1%） by VUS while in 21 PUUs （29.2%） by VCUG （P=0.347）. The two modalities yielded the same results for 65 PUUs （k=0.843）, showing a very good consistency between them. VUS also detected post-urethral valve in 2 patients via transperineal scans. Conclusion VUS with Sonovue has at least comparable, if not better, sensitivity in detecting vesicoureteral reflux with VCUG, and therefore should serve as the primary screening and follow-up modality for vesicoureteral reflux. In addition, transperineal VUS can be helpful in evaluation of post-urethral lesions.

关 键 词：膀胱输尿管返流 超声检查 微气泡 逆行膀胱输尿管造影术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R816.7[医药卫生—诊断学]