肾皮质显像仅后位成像对儿童急性肾盂肾炎的诊断价值

The Diagnostic Value of Renal Cortical Scintigraphy by Single-test ofPosterior Imaging in Children with Acute Pyelonephritis

目的考虑到产生运动伪影的潜在风险,缩短儿童肾皮质显像采集时间是临床迫切需要的。本研究通过比较肾皮质显像后位成像和后斜位成像对儿童急性肾盂肾炎(acute pyelonephritis,APN)的诊断价值,探讨为仅后位成像的可行性。方法收集临床拟诊APN且除外其他肾脏疾病并行肾皮质显像的58例患儿,比较后位成像和后斜位成像对APN的诊断效能。并根据后位图像上病灶的面积分为5组,分析病灶大小与后斜位成像灵敏度的相关性。结果后位图像探测APN的阳性率(44.0%,51/116)高于后斜位(37.1%,43/116),配对χ2检验表明两者阳性率差异有统计学意义(P=0.008<0.05),且在后斜位图像上未发现后位图像上未探测到的病灶。进一步以后位图像上病灶面积大小分为5组,后斜位对各组APN病灶检测的灵敏度分别为0.0%(0/14)、50.0%(9/18)、85.7%(18/21)、93.3%(14/15)和100.0%(22/22),Spearman等级相关分析表明,后斜位图像对APN病灶检测的灵敏度与POST图像上病灶面积大小呈完全正相关(r s=1.00,P<0.01)。结论肾皮质显像后斜位成像不能发现更多的病灶,仅后位成像可以在得到相同诊断信息的前提下有效缩短采集时间。

Objective Given the potential risk of motion artifacts,acquisition duration reduction is desirable in pediatric renal cortical scintigraphy.The aim of this study was to compare the diagnostic values of posterior renal cortical imaging and posterior oblique imaging in children with APN,and to explore the feasibility of single-test of posterior imaging in order to shorten acquisition duration.Methods A total of 58 children with APN without other renal diseases were collected for the study.The diagnostic efficacy of posterior imaging and posterior oblique imaging for APN was compared.According to areas of the lesion on the posterior images,the correlation between the lesion size and the sensitivity of the posterior oblique image was analyzed.Results The positive rate of APN detected in posterior images(44.0%,51/116)was higher than that in posterior oblique images(37.1%,43/116).The pairedχ2 test showed a significant difference in positive rate between the two position images(P=0.008<0.05),and no lesions detected in posterior oblique image were found.Further,the lesion area of posterior image was divided into 5 groups,and the sensitivities of posterior oblique image to APN lesion detection in each group were 0.0%(0/14),50.0%(9/18),85.7%(18/21),93.3%(14/15)and 100.0%(22/22),respectively.Spearman correlation analysis showed that the sensitivity of posterior oblique image to APN lesion detection was positively correlated with the size of lesion in POST image(r s=1.00,P<0.01).Conclusion Oblique imaging method is not able to identify more lesions,while posterior imaging method can effectively shorten the collection duration under the premise of obtaining the same diagnostic information.