多层螺旋CT尿路成像与超声造影在诊断肾结核的对比研究  

Comparative study of multi-slice spiral CT urography and contrast-enhanced ultrasound in the diagnosis of renal tuberculosis

作　　者：桂贞刚 Gui Zhengang(Department of Infectious Diseases,Xuanhan People's Hospital,Dazhou 636150 .China)

机构地区：[1]四川省宣汉县人民医院感染科,达州636150

出　　处：《国际泌尿系统杂志》2019年第4期665-668,共4页International Journal of Urology and Nephrology

摘　　要：目的对比多层螺旋CT尿路成像与超声造影诊断肾结核的效果.方法回顾性分析2015年1月至2017年12月本院疑诊为肾结核的患者174例,其中肾结核105例,其他69例.均已进行多层螺旋CT尿路成像与超声造影,对比诊断效用及两种技术影像学表现.结果多层螺旋CT尿路成像诊断肾结核灵敏度、阴性预测值、符合率高于超声造影,差异有统计学意义(P<0.05),两种技术的特异度、阳性预测值差异无统计学意义(P>0.05).多层螺旋CT尿路成像诊断肾结核的肾实质瘢痕化、肾区钙化率高于超声造影,差异有统计学意义(P<0.05);两种技术显示肾脏形态异常、肾盏异常、肾实质空洞、虫蚀样改变、肾自截、肾外表现、肾盂输尿管壁增厚、积水显示、肾功能减退率差异无统计学意义(P>0.05).结论多层螺旋CT尿路成像诊断肾结核的效用优于超声造影,特别在肾实质瘢痕化、肾区钙化显示方面有一定的优势,但超声造影操作简单、安全、廉价.Objective To compare the effect of multi-slice spiral CT urography and contrast-enhanced ultrasound in the diagnosis of renal tuberculosis. Methods From January 2015 to De-cember 2017, 174 cases of suspected renal tuberculosis were analyzed retrospectively, including 105 cases of renal tuberculosis and 69 other cases. Multi-slice spiral CT urography and contrast-enhanced ultrasound had been performed to compare diagnostic utility and two imaging techniques. Results The sensitivity, negative predictive value and coincidence rate of multi-slice spiral CT urography were higher than those of contrast ultrasound(P<0. 05). There was no significant difference in the spec-ificity and positive predictive value of the two techniques ( P>0. 05 ). The rate of renal parenchyma cicatrization and calcification in renal area was higher than that of contrast-enhanced ultrasound in the diagnosis of renal tuberculosis with multi-slice spiral CT urographic imaging(P<0. 05). The two tech-niques showed that abnormal renal morphology, abnormality of kidney, renal parenchyma cavity, alter-ation of insect erosive sample, kidney self cut, appearance of kidney, thickening of renal pelvis and u-reter wall, and water accumulation, the rate of renal dysfunction were not statistically significant( P>0. 05 ). Conclusions The utility of multi-slice spiral CT urography in the diagnosis of renal tuberculo-sis is superior to that of ultrasound, especially in renal parenchyma scar and renal calcification, but the operation is simple, safe and cheap.

关 键 词：结核 肾 体层摄影术 螺旋计算机 计算机体层摄影血管造影术 

分 类 号：R527.1[医药卫生—内科学] R816.7[医药卫生—临床医学]