动态静脉尿路造影术在上尿路疾病诊断中的价值

目的：比较动态静脉尿路造影术(DIVU)与静脉尿路造影(IVU)在上尿路疾病检查中的应用，探讨DIVU对各种上尿路疾病的诊断价值。方法：158例可疑上尿路病变患行DIVU检查，120例疑上尿路病变患行IVU检查作为对照。对上尿路各部位的显影清晰度进行评分，比较2种检查方法对上尿路各段的显示能力。按病种分类，评价DIVU对各种上尿路疾病的诊断价值，并与IVU比较。结果：正常组DIVU和IVU在显示肾盏、肾孟和上、中段输尿管方面，差异无显性意义。对下段输尿管的显示方面DIVU优于IVU，差异有显性意义(P=0．000)。异常组DIVu对肾盏显示优于IVU，差异有显性意义(P=0．001)；对上、中、下输尿管的显示优于IVU，差异有显性意义(P=0．000)；对于肾孟的显影，DIVU评分高于IVU，但二差异无显性意义。DIVU对重复肾输尿管畸形、上尿路积水的诊断符合率均为100％，高于IVU。结论：DIVU可提高上尿路疾病的诊断率。如疑有上尿路畸形、积水等疾病，可首选DIVU检查。

Clinical study of dynamic intravenous urography in the diagnosis of urinary tract diseases

Objective:To evaluate the ability of dynamic intravenous urography (DIVU) in the evaluation of the upper urinary tract by comparing with intravenous urography (IVU).Methods:158 cases suspected with upper urinary tract disease were imaged by DIVU,other 120 cases underwent IVU for comparison. Opacification scores for the two groups (normal and abnormal cases) of urinary tracts were then compared. Ability of DIVU and IVU was compared in the diagnosis of upper urinary tract disease.Results:The score of DIVU was higher than that of IVU for lower ureters(P=0.000). The score of DIVU was higher than that of IVU for pelvis of the abnormal urinary tracts,the differences in scores were statistically significant(P=0.001).The score of DIVU was higher than that of IVU for upper, middle and lower ureters(P= 0.001). The accuracy rate of DIVU in diagnosing renal duplication and hydronephrosis was 100%, which was higher than that of IVU. DIVU was also more reliable in detecting the ectopic ureteral orifice and ureterocele than IVU.Conclusion:DIVU is a reliable technique for the diagnosis of urinary tract diseases. In patients suspected with congenital anomaly,hydronephrosis etc, DIVU could be selected as the first choice.