NMSCT 输尿管重建联合肾血流图诊断输尿管结石

目的:探讨非增强MSCT(NMSCT)输尿管重建联合肾血流图诊断输尿管结石的价值。方法:采用输尿管重建技术,对162例初步诊断为输尿管结石的患者进行NMSCT扫描,同时行核素肾动态显像检查,结合患者的临床资料,回顾性分析NMSCT联合肾血流图的应用价值。结果:最终明确诊断输尿管结石102例,非输尿管结石60例,结石平均宽度为(7.6±2.8) mm。NMSCT诊断输尿管结石的灵敏度和特异性分别为88.2%、91.7%,肾血流图的灵敏度和特异性分别为83.3%、88.3%,NMSCT联合肾血流图诊断输尿管结石具有最高的灵敏度92.2%和特异性93.3%(表1)。NMSCT显示输尿管结石患者肾积水情况一定程度上能够提示肾血流图显示的泌尿系统梗阻严重程度(即肾功能)。结论:NMSCT输尿管重建可以获得良好的尿路成像,能准确、清晰地显示输尿管结石。NMSCT结合肾血流图可以完成输尿管结石的诊断及肾功能评价。对临床诊断及治疗具有重要价值,可以替代传统CTU检查。

NMSCT Ureteral Reconstruction Combined with Renal Hemodynamics in Diagnosis of Ureteral Calculi

Objective To evaluate the value of non-enhanced MSCT (NMSCT) ureteral reconstruction combined with renal hemodynamics in the diagnosis of ureteral calculi. Methods Patients (162 cases) with primary diagnosis of ureteral calculi were scanned with NMSCT and radionuclide renal dynamic imaging. The clinical data were analyzed retrospectively. Results Patients with ureteral calculi ( 102 cases) and of non- ureteral calculi ( 60 cases) were diagnosed definitely. The average width of calculi was ( 7 . 6 ± 2 . 8 ) mm. The sensitivity and specificity of NMSCT in the diagnosis of ureteral calculi were 88.2% and 91.7%, respectively. The sensitivity and speci?city of renal hemodynamics were 83.3% and 88.3%, respectively. The highest sensitivity and speci?city of NMSCT combined with renal hemodynamics in the diagnosis of ureteral calculi were 92.2% and 93.3%. NMSCT showed hydronephrosis in patients with ureteral calculi, and to some extent, could indicate the severity of urinary obstruction (renal function) shown by renal ?ow chart. Conclusion NMSCT ureteral reconstruction can obtain good urography and display ureteral calculi accurately and clearly. The diagnosis of ureteral calculi and evaluation of renal function can be accomplished by combining NMSCT with renal blood ?ow imaging. It has important value for clinical diagnosis and treatment, and can replace traditional CTU examination.