CT值对肾积水合并感染的诊断价值

The clinical value of CT attenuation values diagnosis of hydronephrosis with infection

目的探讨CT值在肾积水合并感染患者诊断中的价值及临床意义。 方法回顾性分析2014年6月至20l6年6月收治的185例上尿路结石合并肾积水患者的临床资料。男82例，女103例。年龄（52.2±13.1）岁，范围18～80岁。其中无感染肾积水58例，急性肾盂肾炎55例，肾积脓72例。患者术前均行CT检查。比较无感染肾积水、急性肾盂肾炎、肾积脓3组患者肾盂内尿液CT值的差异。 结果无感染肾积水组CT值（5.61±3.67）HU，95%CI（4.64～6.57）HU；急性肾盂肾炎组CT值（8.35±5.63）HU，95%CI（6.83～9.87）HU；肾积脓组CT值（13.92±6.21）HU，95%CI（12.46～15.38）HU。无感染肾积水组与急性肾盂肾炎组CT值比较差异有统计学意义（P〈0.01），肾积脓组CT值明显高于急性肾盂肾炎组和无感染肾积水组，差异有统计学意义（P〈0.01）。 结论肾盂内尿液CT值在一定程度上能够预测肾内感染情况，术前通过CT值评估肾积水是否合并感染具有一定的临床意义。

ObjectiveTo investigate the diagnostic and clinical significance of computerized tomography （CT） attenuation values （hounsfield unit, HU） in hydronephrosis with infection. MethodsOne hundred and eighty-five cases of upper urinary tract calculi with hydronephrosis from June 2014 to June 2016 were retrospectively analyzed. There were 82 males and 103 females with a mean age of （52.3±13.1）years old, ranging 18-80 years old. 58 cases suffered hydronephrosis without infection, 55 cases suffered acute pyelonephritis and 72 cases suffered pyonephrosis. The CT attenuation values of the renal pelvis urine in three groups were measured. ResultsThe CT attenuation value of hydronephrosis without infection group was （5.61±3.67）HU, 95%CI（4.64-6.57）HU . In acute pyelonephritis group, CT attenuation value was （8.35±5.63）HU, 95%CI（6.83-9.87）HU. In pyonephrosis group, the CT attenuation value was （13.92±6.21）HU, 95%CI （12.46-5.38）HU. The CT attenuation value of pyelonephritis compared with that of hydronephrosis without infection was significant different.（P〈0.01）. The CT attenuation value of the patients with pyonephrosis was significantly higher than that of patients without infection and with pyelonephritis （P〈0.01）. ConclusionsThe CT attenuation value of renal pelvis urine can predict intrarenal infection. Furthermore, The measurement of CT attenuation value has some clinical significance in preoperative evaluation of hydronephrosis with infection.