双低剂量MSCT尿路造影在泌尿系梗阻性疾病诊断价值的研究(1)

http://www.100md.com 2018年1月5日 中国医学创新 2018年第1期

     【摘要】 目的：探究雙低剂量多层螺旋CT(MSCT)尿路造影在泌尿系统梗阻性疾病中的诊断价值。方法：回顾性分析2016年1月-2017年8月于本院经病理检查或手术确诊为尿路梗阻性疾病的60例患者的临床资料，采用常规剂量MSCT尿路造影检查者纳入常规剂量组，采用低对比剂用量及低辐射剂量MSCT尿路造影检查者纳入双低剂量组，每组各30例。比较两种检查方法的诊断效能，探讨并分析双低剂量MSCT尿路造影的诊断价值。结果：两组病例图像质量评分都超过4分，都可以满足诊断要求，双低剂量组平均分值约4.53分，常规剂量组平均分值约4.60分，两组比较差异无统计学意义(P>0.05)。两组对泌尿系结石、泌尿系肿瘤、泌尿系炎症和泌尿系畸形诊断的特异度均为0，常规剂量组对泌尿系结石的敏感度、准确度均为95.8%，泌尿系肿瘤敏感度、准确度均为66.7%，泌尿系炎症敏感度、准确度均为50.0%泌尿系畸形敏感度、准确度均为100%。双低剂量组对泌尿系结石的敏感度、准确度均为91.7%，泌尿肿瘤敏感度、准确度均为50.0%，泌尿系炎症、泌尿系畸形敏感度、准确度均为100%。两组准确度比较，差异均无统计学意义(P>0.05)。双低剂量组对比剂使用量和辐射剂量均显著低于常规剂量组，两组比较差异均有统计学意义(P<0.05)。结论：双低剂量MSCT尿路造影检查结合三维重建等技术能对泌尿系梗阻疾病进行诊断，且诊断效能与常规剂量MSCT尿路造影相同，对比剂使用量和辐射剂量更少，安全性更高，具有在临床上推广应用的价值。

    【关键词】 多层螺旋CT； 泌尿系梗阻性疾病； 尿路造影； 诊断价值

    Diagnostic Value of Dual Low-dose MSCT Urography in Urinary Obstructive Diseases/YANG Yunxia，ZHANG Bochang，ZHU Rang，et al.//Medical Innovation of China，2018，15(01)：018-021

    【Abstract】 Objective：To investigate the diagnostic value of double low-dose multi-slice spiral CT (MSCT) urography in urinary system obstructive diseases.Method：The clinical data of 60 patients with urinary tract obstruction diagnosed by pathology or operation in our hospital from January 2016 to August 2017 were retrospectively analyzed.Routine dose MSCT urography was the conventional dose group，the low-dose MSCT urography was the low-dose group，30 cases in each group.The diagnostic efficacy of two groups were compared and analyzed.Result：The scores of the two groups were more than 4 points， which could meet the diagnostic requirements.The average score of the double low dose group was about 4.53 points and the average score of the conventional dose group was about 4.60 points，there was no significant difference between the two groups(P>0.05).The specificity of the two groups was 0 for the diagnosis of urinary calculi， urinary tract， urinary tract inflammation and urinary malformations.The sensitivity and accuracy of conventional dose group for urinary calculi were respectively 95.8%，urinary tumor sensitivity and accuracy were respectively 66.7%，urinary system inflammation sensitivity and accuracy were respectively 50.0%，urinary tract malformation sensitivity and accuracy were 100%.The sensitivity and accuracy of double low dose group for urinary calculi were respectively 91.7%，urinary tumor sensitivity and accuracy were respectively 50.0%，urinary system inflammation and urinary system malformation sensitivity and accuracy were respectively 100%.The accuracy of the two groups was not statistically significant(P>0.05).The contrast agent dose and radiation dose of the double low dose group were significantly lower than that of the conventional dose group，the differences were statistically significant(P<0.05).Conclusion：The technique of double low dose MSCT combined with three-dimensional reconstruction can diagnose urinary tract obstruction disease.The diagnostic efficacy is the same as that of conventional dose MSCT urography.The contrast agent dosage and radiation dose are less，the safety is higher，it has the value of popularization and application in clinical practice.(仰涢霞 张柏昌 朱让 周耀明)

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