小剂量碘海醇IVP联合逆行尿路造影诊断输尿管狭窄  

Diagnosis of ureterostenoma by low-dose iohexol IVP combined with cystoscopic urography

作　　者：李曼[1] 黄柱飞[1] 商雪林[1] 莫春开[1] 

机构地区：[1]解放军303医院放射科,南宁530021

出　　处：《西南国防医药》2013年第11期1189-1192,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的评价小剂量碘海醇静脉肾盂造影联合逆行尿路造影对输尿管狭窄的诊断价值。方法收集我院2007年1月-2012年12月临床高度怀疑输尿管狭窄的患者163例，其中49例经签署知情同意书人选A组，进行小剂量（10ml，0．2g／kg）碘海醇静脉肾孟造影，其他114例入选B组，行常规剂量碘海醇静脉肾盂造影。所有静脉肾盂造影输尿管不显影或显影不满意者加做逆行尿路造影。结果A组检出输尿管狭窄13例（26．5％），联合逆行尿路造影检出输尿管狭窄29例（59．2％）；B组检出输尿管狭窄31例（27．2％），联合尿路逆行造影检出输尿管狭窄66例（57．9％）。A、B两组静脉。肾盂造影对输尿管狭窄确诊率无明显差异（Х^2=0．008，P〉0．05）；联合逆行尿路造影，A、B两组对输尿管狭窄的检出率分别为85．7％、85．1％。结论小剂量与常规剂量碘海醇静脉肾孟造影对输尿管狭窄的检出无明显差异，但单纯静脉肾盂造影对输尿管狭窄的检出率低，需结合逆行尿路造影。小剂量碘海醇静脉肾盂造影具有风险小、成本低的优点，尤其适合合并肾功能不全的患者，可达到同等的检查目的，值得推广应用。Objective To evaluate the value of low-dose iohexol intravenous pyelography （IVP） combined with retrograde urography in the diagnosis of ureterostenoma. Methods 163 patients who were highly suspected suffering from ureterostenoma between January 2007 and December 2012 were selected as subjects. Forty nine cases who had signed informed consent forms were chosen as group A and received the low-dose （ 10 m1,0.2 g/kg） iohexol IVP. Other 114 patients were choen as group B and received regular dose iohexol IVP. The patients whose IVP images were nonvisulization or had unsatisfactory visualization received cystoscopic urography. Results In group A,ureterostenoma was diagnosed in 13 cases （26.5%） by IVP,and other 29 cases （59.2%） of ureterostenoma were identified by IVP combined with retrograde urography. In group B,31 cases （27.2%） of ureterostenoma were diagnosed by IVP, while other 66 ones （57.9%） were identified by IVP combined with retrograde urography. There was no difference in the diagnosis rate of ureterostenoma by IVP between the two groups （Х^2 = 0.008 ,P 〉 0.05 ）. The detection rates of ureterostenoma by the combination of retrograde urography in group A and B were 85.7% and 85.1% respectively. Conclusion There is no significant difference between the detection rates of ureterostenoma by low and regular dose iohexol IVP. But the detection rate of ureterostenoma by simple IVP is low. The low-dose iohexol IVP has the advantages of low risk and cost especially for patients with renal insufficiency.

关 键 词：碘海醇 剂量 肾盂造影 逆行尿路造影 输尿管 狭窄 

分 类 号：R693.2[医药卫生—泌尿科学]