应用B型超声联合多层螺旋CT检查对肾结核的诊断价值分析

目的分析应用B型超声联合多层螺旋CT检查对肾结核的诊断价值。方法选取我院2017年6月~2018年4月收治的肾结核患者53例,收集患者临床及影像学资料,总结肾结核在经腹壁超声及多层螺旋CT检查中的图像表现,计算两种检查联合对肾结核的诊断灵敏度及特异度。结果超声对肾结核的诊断灵敏度及特异度分别为88.04%、85.86%,多层螺旋CT对肾结核的诊断灵敏度及特异度分别为90.21%、88.04%,两者比较无统计学差异(P>0.05);超声联合多层螺旋CT对肾结核的诊断灵敏度及特异度分别为98.91%、97.82%,明显高于超声、多层螺旋CT检查,差异有统计学意义(P<0.05);超声表现可见实质回声不均匀,肾内、肾盏内出现液暗区及强回声团,集合系统紊乱分离;14例患者可见肾盂扩张,内部无回声透声差,部分见絮状沉积物;21例图像显示肾被膜不规则,肾实质回声不均匀,伴散在的点、团状强回声。CT平扫可见患者肾内出现低密度空洞,大小形态不一,围绕肾盂分布,CT值0-31Hu,增强后周边呈环状增强,内部无明显强化;20例患者出现肾脏形态失常,体积明显缩小,局部肾皮质厚度变薄,边缘不规整,内部密度不均匀,增强扫描后出现稍增强。结论应用B型超声、多层螺旋CT检查均可有效显示肾结核影像学特征,两者联合检查可有效提高诊断灵敏度及特异度。

Diagnostic Value of B-mode Ultrasound Combined with Multi-slice Spiral CT in Renal Tuberculosis

Objective To analyze the diagnostic value of B-mode ultrasound combined with multi-slice spiral CT in renal tuberculosis.Methods 53 patients with renal tuberculosis admitted to our hospital from June 2017 to April 2018 were selected.The clinical and imaging data of the patients were collected.The imaging manifestations of renal tuberculosis in transabdominal ultrasound and multi-slice spiral CT were summarized.The sensitivity and specificity of the two combined examinations in the diagnosis of renal tuberculosis were calculated.Results The sensitivity and specificity of ultrasound in diagnosis of renal tuberculosis were 88.04%and 85.86%,respectively.The sensitivity and specificity of multi-slice spiral CT in diagnosis of renal tuberculosis were 90.21%and 88.04%,respectively.There was no significant difference between the two methods(P>0.05).The sensitivity and specificity of ultrasound combined with multi-slice spiral CT in the diagnosis of renal tuberculosis were 98.91%and 97.82%respectively,which were significantly higher than those of ultrasound and multi-slice spiral CT,the difference was statistically significant(P<0.05).Ultrasound showed uneven echo in the parenchyma.Dark and liquid areas and strong echoes appeared in the kidney and renal calices,and the collecting system was disordered and was separated.In 14 cases,pyelomegaly was observed,with no-echo and flocculent sediments in part.The images of 21 cases showed irregular renal capsule,uneven renal parenchyma and accompanied by scattered,punctate and masses-like strong echoes.On plain CT scan,there were low density holes in the kidneys of the patients with different sizes and shapes.They were distributed around the renal pelvis.The CT value ranged from 0 to 31 Hu.After enhancement,the periphery showed reinforcement like ring,and there was no obvious strengthening inside.20 patients showed abnormal renal shape,the volume was significantly reduced,and the thickness of the local renal cortex became thin,the edge was irregular,the inside density of kidney was not uniform,slightly was enhanced after enhanced scan.Conclusion Both B-mode ultrasound and multi-slice spiral CT can effectively display the imaging features of renal tuberculosis,and their combined examination can effectively improve the sensitivity and specificity of diagnosis.