低剂量碘海醇CT尿路造影应用在小儿肾积水检查中的价值

The value of low-dose iohexol CT urography in the examination of children with hydronephrosis

目的研究低剂量碘海醇CT尿路造影应用在小儿肾积水检查中的价值。方法50例肾积水患儿为研究对象,均接受低剂量碘海醇CT尿路造影和静脉尿路造影。以病理组织学诊断为最终诊断的金标准,比较两种检查方法的尿路显影率与假阴性率,不同程度肾积水患儿低剂量碘海醇CT尿路造影检查的图像评级。结果低剂量碘海醇CT尿路造影检查的尿路显影率94%明显高于静脉尿路造影的66%,假阴性率0明显低于静脉尿路造影的16%,差异具有统计学意义(P<0.05)。50例患儿中,轻度肾积水26例、中重度肾积水24例。轻度肾积水患儿低剂量碘海醇CT尿路造影检查图像优良率100%明显高于中重度肾积水患儿的83%,差异具有统计学意义(P<0.05)。结论肾积水患儿行低剂量碘海醇CT尿路造影的尿路显影率高,可有效降低假阴性率。在实际应用中,应根据肾积水的病因和程度调整肾排泄期的扫描延迟时间,以获得最佳的全尿路图像。

Objective To study the value of low-dose iohexol CT urography in the examination of children with hydronephrosis.Methods 50 children with hydronephrosis were taken as the subjects of the study,and all received low-dose iohexol CT urography and intravenous urography.With histopathological diagnosis as the gold standard for the final diagnosis,the difference between the two methods of displaying rate and falsenegative rate,as well as the difference in the grading of low-dose iohexol CT urography in children with different degrees of hydronephrosis,was compared.Results The displaying rate 94%low-dose iohexol CT urography was significantly higher than 66%of intravenous urography,and the false-negative rate 0 was significantly lower than 16%of intravenous urography,and the difference was statistically significant(P<0.05).Among the 50 children,26 cases had mild hydronephrosis and 24 cases had moderate to severe hydronephrosis.The excellent rate of lowdose iohexol CT urography in children with mild hydronephrosis was 100%,which was obviously higher than 83%in children with moderate to severe hydronephrosis,and the difference was statistically significant(P<0.05).Conclusion Low-dose iohexol CT urography has a high displaying rate in children with hydronephrosis,which can effectively reduce the false-negative rate.In practical applications,the scan delay time during the renal excretion phase should be adjusted according to the cause and degree of hydronephrosis to obtain the best overall urinary tract image.