CT尿路成像检查在儿童先天性肾脏和尿路畸形诊断中的应用  

Application of CT urography detection in diagnosis of congenital anomalies of kidney and urinary tract in children

作　　者：葛宁 杨文忠[1] 张莎莎[2] 李紫薇 华方竹 Ge Ning;Yang Wenzhong;Zhang Shasha;Li Ziwei;Hua Fangzhu(Department of Radiology,Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,Hubei Province,China;Department of Pharmacy,Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,Hubei Province,China)

机构地区：[1]湖北省妇幼保健院医学影像科,武汉430070 [2]湖北省妇幼保健院药剂科,武汉430070

出　　处：《中华妇幼临床医学杂志（电子版）》2021年第1期114-119,共6页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：湖北省卫生计生委科研课题(WJ2018H0136)。

摘　　要：儿童先天性肾脏和尿路畸形(CAKUT)是由于胚胎期肾脏和泌尿道发育缺陷所致,以先天性泌尿系统解剖结构异常为主要临床特征、临床表型多样的一组疾病。CT尿路成像(CTU)是指利用多层螺旋CT进行全尿路造影检查,并对获得的图像进行后处理与重建,用于诊断各种泌尿系统疾病的影像学技术。受试儿肾排泄期,当泌尿系统充满碘造影剂时呈高密度显影,与周围低密度软组织形成良好对比,为CTU技术应用于CAKUT患儿检查提供依据。笔者拟就儿童CAKUT种类及发病机制,不同影像学诊断方法比较,CTU检查要点,以及降低CTU辐射剂量等的最新研究进展进行阐述,旨在为临床应用CTU诊断CAKUT患儿时,最大限度降低受试儿的电离辐射损伤提供参考。Congenital anomalies of kidney and urinary tract(CAKUT)in children are caused by embryonic developmental defects of kidneys and urinary tract.CAKUT,as a group of diseases with diverse chinical phenotypes,congenital anatomical abnormalities of urinary system are its main clinical features.CT urography(CTU)refers to the use of multi-slice spiral CT to perform angiography of whole urinary tract,and to post-process and reconstruct the obtained images to diagnose various urinary system diseases.During the excretion phase of CTU,urinary tract is filled with iodine contrast agent and shows high density development.It provides a good contrast with the surrounding low-density soft tissue,providing a basis for application of CTU in CAKUT children.This article mainly elaborates on latest research progress of different types and pathogenesis of CAKUT in children,comparison of different imaging diagnostic methods of CAKUT,the main points of CTU detection in CAKUT children,and how to reduce CTU radiation dose,etc.,in order to provide a reference for minimizing radiation damage of CTU detection in CAKUT children.

关 键 词：尿路造影术 泌尿生殖系统畸形 先天畸形 先天性肾脏和尿路畸形 体层摄影术 X线计算机 辐射剂量 儿童 

分 类 号：R726.9[医药卫生—儿科]