肾结核患者CTU成像特征分析

Imaging features and diagnostic value of multi-slice spiral CT urography in paticents with renal tuberculosis

目的分析肾结核患者多层螺旋CT尿路造影(CTU)的影像学特点,为肾结核的诊断提供依据。方法选取2016-01-12-2020-06-30新乡医学院第一附属医院就诊的78例泌尿系感染患者为研究对象,患者均行CTU检查。以手术病理结果诊断肾结核为金标准,分为肾结核组(42例)和普通泌尿系感染组(36例)。采用单因素及多因素Logistic回归分析方法,筛选肾结核CTU的影像学特点。结果单因素分析结果显示,肾结核组患者的部分CTU特征明显高于普通泌尿系感染患者,主要表现为肾体积缩小(χ^(2)=11.375,P=0.001)、肾脓肿(χ^(2)=40.386,P<0.001)、肾盏或肾盂壁增厚(χ^(2)=16.473,P<0.001)、输尿管壁增厚(χ^(2)=31.780,P<0.001)和膀胱壁增厚(χ^(2)=4.619,P=0.032)。多因素Logistic回归分析显示肾脓肿(P=0.002)、肾盏或肾盂壁增厚(P=0.043)及输尿管壁增厚(P=0.024)等的影像表现与肾结核有关系,差异均有统计学意义。结论肾结核患者的影像学表现具有一定特征性,肾脓肿、肾盏或肾盂壁增厚及输尿管壁增厚等可为肾结核的诊断提供依据。

Objective To analyze the imaging characteristics of multi-slice spiral CT urography(CTU)in patients with renal tuberculosis,so as to provide basis for the diagnosis of renal tuberculosis.Methods From 2016-01-12 to 2020-06-30,78 patients with urinary tract infection of the First Affiliated Hospital of Xinxiang Medical College were retrospectively analyzed.All patients underwent CTU examination.According to the gold standard of diagnosis of renal tuberculosis by the surgical pathological results,they were divided into renal tuberculosis group(42 cases)and common urinary infection group(36 cases).Univariate and multivariate logistic regression analysis were used to screen the imaging characteristics of CTU of renal tuberculosis.Results Univariate analysis showed that some CTU features of renal tuberculosis patients were significantly higher than those of common urinary tract infection patients,mainly manifesting as renal volume reduction(χ^(2)=11.375,P=0.001),renal abscess(χ^(2)=40.386,P<0.001),calyceal or pelvic wall thickening(χ^(2)=16.473,P<0.001),ureteral wall thickening(χ^(2)=31.780,P<0.001)and bladder wall thickening(χ^(2)=4.619,P=0.032).Multivariate logistic regression analysis showed that the imaging manifestations of renal abscess(P=0.002),thickening of renal calyces or renal pelvis wall(P=0.043)and thickening of ureteral wall(P=0.024)were related to renal tuberculosis,and the differences were statistically significant.Conclusions The imaging manifestations of patients with renal tuberculosis have certain characteristics.Renal abscess,thickening of renal calyces or renal pelvis wall and thickening of ureteral wall can provide basis for the diagnosis of renal tuberculosis.