低剂量对比剂CT尿路成像在妇产科术后泌尿系损伤中的诊断价值  

Diagnostic value of low-dose contrast agent CT urography in urinary system injury after gynecological and obstetric operations

作　　者：潘文静 屈鹏飞 闫锐 PAN Wenjing;QU Pengfei;YAN Rui(Northwest Women's and Children's Hospital,Xi'an 710061;Shaanxi University of Chinese Medicine,Xianyang 712046,China)

机构地区：[1]西北妇女儿童医院,陕西西安710061 [2]陕西中医药大学,陕西咸阳712046

出　　处：《临床医学研究与实践》2022年第6期132-135,共4页Clinical Research and Practice

摘　　要：目的探讨低剂量对比剂CT尿路成像(CTU)在妇产科术后泌尿系损伤中的诊断价值。方法回顾性分析2016年6月至2020年12月我院妇产科手术后行CTU检查的40例可疑泌尿系损伤患者的临床资料以及影像学资料。将2016年6月至2019年8月收治的患者设为A组(26例),对比剂用量为1.5 mL/kg,行CT平扫、皮质期、髓质期以及排泄期扫描;将2019年9月至2020年12月收治的患者设为B组(14例),对比剂用量为0.8 mL/kg,行CT平扫、皮质期、髓质期以及排泄期扫描。排泄期图像采用多平面重组(MPR)、最大密度投影(MIP)以及容积再现(VR)等方法重建。由两位高年资诊断医师在不了解扫描方案的情况下对两组CT扫描横断图像及重建图像进行质量评价;分析两种CTU方案与手术及临床随访结果对泌尿系损伤的诊断一致性。结果 B组患者的对比剂用量为(47.2±5.3)mL,显著少于A组的(84.6±5.7)mL(P<0.05)。两组患者的图像质量比较,差异无统计学意义(P>0.05)。A组、B组CTU方案与手术及临床随访结果对泌尿系损伤的诊断一致性均良好(Kappa=0.952、0.909)。结论低剂量对比剂CTU能够满足妇产科手术后可疑泌尿系损伤的诊断。Objective To explore the diagnostic value of low-dose contrast agent computed tomography urography(CTU) in urinary system injury after gynecological and obstetric operations.Methods The clinical and imaging data of 40 patients with suspected urinary system injury who underwent CTU examination after gynecological and obstetric operations in our hospital from June 2016 to December 2020 were analyzed retrospectively.The patients admitted from June 2016 to August 2019 were set as group A(26 cases),the dosage of contrast agent was 1.5 mL/kg,and CT plain scanning,cortical phase,medullary phase and excretory phase scanning were performed for the patients;the patients admitted from September 2019 to December 2020 were set as group B(14 cases),the dosage of contrast agent was 0.8 mL/kg,and CT plain scanning,cortical phase,medullary phase and excretory phase scanning were performed for the patients.The excretory phase images were reconstructed by multiplanar reconstruction(MPR),maximum intensity projection(MIP) and volume rendering(VR).Two senior diagnostic physicians evaluated the quality of CT scanning cross-sectional images and reconstructed images of the two groups without understanding the scanning scheme;and the diagnostic consistency between the two CTU schemes and the results of operation,clinical follow-up for urinary system injury were analyzed.Results The dosage of contrast agent in the group B was(47.2±5.3) mL,which was significantly less than(84.6±5.7) mL in the group A(P<0.05).There was no significant difference in image quality between the two groups(P>0.05).There were good diagnostic consistency between the group A and B CTU schemes and the results of operation,clinical followup for urinary system injury(Kappa=0.952,0.909).Conclusion Low-dose contrast agent CTU can meet the diagnosis of suspected urinary system injury after gynecological and obstetric operations.

关 键 词：CT尿路成像 妇产科手术 低剂量对比剂 泌尿系损伤 

分 类 号：R445.3[医药卫生—影像医学与核医学] R714.258[医药卫生—诊断学]