膀胱腔增强超声造影对小儿膀胱输尿管反流严重程度的判定价值及对手术指导意义  

Value of contrast-enhanced bladder cavity contrast-enhanced ultrasonography in judging the severity of vesicoureteral reflux in children and its significance for surgical guidance

作　　者：王军屏[1] 王晓曼 杨斌[1] 马亚丽 王强 邸志彦 赵沙沙 WANG Junping;WANG Xiaoman;YANG Bin;MA Yai;WANG Qiang;DI Zhiyan;ZHAO Shasha(Department of Ultrasonography,the Children Hospital of Baoding,Baoding,Hebei 071000,China)

机构地区：[1]保定市儿童医院超声科,河北保定071000

出　　处：《安徽医药》2023年第8期1629-1633,共5页Anhui Medical and Pharmaceutical Journal

基　　金：保定市科技计划项目(1951ZF081)。

摘　　要：目的探讨膀胱腔增强超声造影对小儿膀胱输尿管反流(VUR)严重程度的判定价值及对手术指导意义。方法选取保定市儿童医院2018年1月至2021年4月小儿尿路感染病儿82例作为研究对象,均行膀胱腔增强超声造影检查,以排泄性膀胱尿路造影(VCUG)为金标准,分析膀胱腔增强超声造影对小儿VUR及其严重程度的诊断价值,并分析膀胱腔增强超声造影与VCUG检查对手术效果的评价一致性。结果82例尿路感染病儿,共151个肾输尿管单位(PUUs),VCUG确诊59个PUUs为VUR;膀胱腔增强超声造影检出57个PUUs阳性;ROC曲线分析,膀胱腔增强超声造影诊断VUR的AUC为0.98;经一致性分析,膀胱腔增强超声造影与VCUG检查诊断小儿VUR严重程度一致性极高;42个PUUs的VUR严重程度达Ⅲ度及以上,术后6个月VCUG评估缓解率为95.24%;膀胱腔增强超声造影评估缓解率为95.24%,一致性分析,膀胱腔增强超声造影与VCUG检查对手术效果的评价一致性极高。结论膀胱腔增强超声造影在小儿VUR及其严重程度中具有较高诊断价值,还能较为可靠地评价手术效果,可作为疾病诊断、病情判定、术前指导及术后疗效评估的重要手段。Objective To investigate the value of contrast-enhanced ultrasonography of the bladder cavity in judging the severity of vesicoureteral reflux(VUR)in children and its significance for surgical guidance.Methods A total of 82 children with urinary tract infection in the Children Hospital of Baoding from January 2018 to April 2021 were selected as the research subjects.All of them underwent contrast-enhanced ultrasonography of the bladder cavity.Taking voiding cystourethrography(VCUG)as the gold standard,the diagnostic value of contrast-enhanced endoscopic ultrasonography in children with VUR and its severity,and the consistency of contrast-enhanced ultrasonography of bladder and VCUG in evaluating the surgical effect were analyzed.Results There were 151 renal ureteral units(PUUs)in 82 children with urinary tract infection,59 PUUs were diagnosed as VUR by VCUG;57 PUUs were positive by contrast-enhanced bladder ultrasonography;ROC curve analysis showed that VUR was diagnosed by contrast-enhanced bladder ultrasonography,the AUC was 0.98;the consistency analysis showed that the contrast-enhanced bladder cavity and VCUG examinations were very consistent in the diagnosis of the severity of VUR in children;the VUR severity of 42 PUUs was gradeⅢor above,and the assessment of remission rate was 95.24%by VCUG at 6 months after surgery,the assessment of remission rate was 95.24%by contrast-enhanced bladder cavity contrast-enhanced ultrasonography.Consistency analysis showed that contrast-enhanced contrast-enhanced ultrasonography of the bladder cavity and VCUG examination had extremely high consistency in evaluating the surgical effect.Conclusion Contrast-enhanced bladder cavity ultrasonography has high diagnostic value in children with VUR and its severity,and can more reliably evaluate the effect of surgery,which can be used as an important means for disease diagnosis,condition determination,preoperative guidance and postoperative efficacy evaluation.

关 键 词：膀胱输尿管反流 膀胱腔增强超声造影 排泄性膀胱尿路造影 儿童 

分 类 号：R726.9[医药卫生—儿科]