个体化低剂量CTU在上尿路梗阻性疾病诊断中的可行性研究  

Feasibility of individualized low-dose CTU in the diagnosis of upper urinary tract obstructive diseases

作　　者：胡敬花[1] Hu Jinghua(CT Room, Heze Municipal Hospital, Heze 274031, China)

机构地区：[1]山东省菏泽市立医院CT室,274031

出　　处：《中国实用医刊》2018年第9期56-59,共4页Chinese Journal of Practical Medicine

摘　　要：目的 探讨个体化低剂量CT尿路成像（CTU）在上尿路梗阻性疾病诊断中的可行性.方法 对112例上尿路梗阻性疾病患者行个体化低剂量CTU检查,常规剂量（成人120 kV/300 mAs、儿童120 kV/85 mAs）平扫、皮髓质期及实质期扫描后,再根据患者年龄降低扫描预设参数（成人120 kV/150 mAs、儿童100 kV/50 mAs）行低剂量分泌期扫描,同时针对不同病因、不同梗阻部位上尿路梗阻性疾病患者行个体化选择重点扫描期相扫描,优化扫描序列.对所获容积数据进行最大密度投影、多平面重建、容积再现和曲面重建三维后处理,以手术病理及临床治疗证实结果为标准,比较CTU与静脉肾盂造影（IVP）、磁共振尿路造影（MRU）的诊断准确率.同时记录每例患者的剂量长度积（DLP）并求其平均值作为辐射剂量的观测指标.结果 个体化低剂量CTU作为无创性检查技术,对尿路结石及其梗阻平面以及尿路畸形的诊断准确率可达100％,明显高于IVP的82.2％（尿路结石）、75.4％（尿路畸形）和MRU的84.6％（尿路结石）、95.4％（尿路畸形）,P〈0.05.低剂量CTU在图像合格率达97.3％的同时,较常规剂量CTU成人及儿童辐射剂量分别下降了53.5％、65.4％.结论 个体化低剂量CTU在上尿路梗阻性疾病诊断中具有显著的优势,在保证图像质量的同时,明显减少了患者受辐射剂量,是较常规CTU扫描更为人性化的扫描方式,可作为上尿路梗阻性疾病患者的首选影像学检查方法.Objective To investigate the value of individualized low-dose computed tompgraphy urography （CTU） in diagnosing the upper urinary tract obstructive diseases. Methods A total of 112 patients with upper urinary tract obstruction underwent individualized low-dose CTU, conventional dosage plain scan （120 kV/300 mAs for adults, 120 kV/85 mAs for children） , corti comedullary phase and pa-renchymal phase scan, at first; and then they underwent low-dose secretory phase scan with decreasing parameters according to the age of patients （120 kV/150 mAs for adults, 100 kV/50 mAs for children） ; at the same time, patients were given different enhanced scanning, and optimized scanning sequence ac-cording to pathogens and obstruction sites of upper urinary tract obstructive diseases. The volume data of all patients were reconstructed with 3D reconstruction techniques including maximum intensity projection （MIP）, multiple plane reformation （MPR）, and volume rendering technique （VR）, and curve plane reformation（CPR）. The diagnostic accuracy for CTU by intravenous pyelography （IVP） and magnetic resonance urography （MRU） were compared with the surgery and pathology results as standards. At the same time, the dose length product （DLP） of each case was recorded and the mean value was measured as the observation index of radiation dose. Results The individualized low-dose CTU was a non-invasive examination, compared with the surgical pathology and clinical treatment, its diagnastic accuracy for uri-nary stones, obstruction of plane and urinary tract malformation was 100% , which was significantly high-er than the 82.2% (urinary stones）, 75.4% (urinary tract malformation） of IVP and the 84. 6% (uri-nary stones）, 95.4% (urinary tract malformation） of MRU (P 〈 0. 05). At the same time, the qualifiedrate of low dose CTU reached 97.3%, while the radiation dose of CTU adults and children decreased by 53.5% and 65.4% , respectively. Conclusions The low dose CTU has significant advantages in t

关 键 词：上尿路梗阻性疾病 低剂量CT尿路成像 诊断价值 

分 类 号：R691.2[医药卫生—泌尿科学]