Retrospective Analysis of Multidetector Spiral CT Contrast Enhanced Scan for Chronic Pyelonephritits_West China Medical Journal

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the Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

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Keywords：

慢性腎盂腎炎; 增強掃描; 多層螺旋CT; 靜脈腎盂造影

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目的:研究多層螺旋CT(MDCT)增強掃描對慢性腎盂腎炎的診斷價值。方法:病例組:2008年3月至2009年3月經我院診治的慢性腎盂腎炎患者30例,均行MDCT增強掃描及靜脈腎盂造影(IVP)檢查,兩者間隔時間不超過1周;對照組:同期無腎臟疾患,無尿路感染史,因其他原因來做腹部CT增強掃描的患者25例。由兩名不同年資的腹部影像醫師對擬定的征象進行觀察、評價。結果:兩醫師對本組病例的診斷一致性極佳K=0.812,P lt;0.05)。病例組30例,雙腎病變14例,單腎病變16例。單腎病變中,左腎12例,右腎4例。MDCT增強掃描顯示腎盞輕度變形2例(6.7%),腎盞裸露18例(60.0%),實質凹陷征23例(76.7%),腎盂輕度擴張積水21例(70.0%),腎盂壁增厚、強化21例(70.0%),腎功能減退15例(50.0%)。5例(16.7%)僅表現為腎盂壁增厚、強化。MDCT增強掃描與IVP對腎實質凹陷征,腎盂壁增厚、強化及腎盞輕度變形的顯示率有統計學差異(P lt;0.05)。結論:MDCT增強掃描能清晰地顯示慢性腎盂腎炎的病理變化。與IVP比較,它能提供更多腎實質的信息,對判定慢性腎盂腎炎所造成的腎臟損害程度及疾病預后具有很高的價值,不過對腎盞輕度變形的顯示有賴于延遲掃描。

Citation： ZHOU Haiying,SHANG Lan,DENG Kaihong,et al. Retrospective Analysis of Multidetector Spiral CT Contrast Enhanced Scan for Chronic Pyelonephritits. West China Medical Journal, 2009, 24(7): 1788-1791. doi: Copy

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2. 蔣季杰,范亞平主編.現代腎臟病學[M].北京:人民軍醫出版社,2001:628-648..
3. 魏經國主編.影像診斷病理學[M].西安:第四軍醫大學出版社,2007:334-335..
4. CRAIG W D, WAGNER B J, TRAVIS M D. Pyelonephritis: RadiologicPathologic[J]. Radiographics,2008,28(1):255-276..
5. BROWNE R F, ZWIREWICH C, TORREGGIANI W C. Imaging of urinary tract infection in the adult[J]. Eur Radiol,2004,14:E168-E183..
6. LAVOCAT M P, GRANJON D, ALLARD D, et al. Imaging of pyelonephritis[J]. Pediatr Radiol,1997,27:159-165..
7. KENNEY P J. Imaging of chronic renal infections[J]. Am J Roentgenol,1990,155:485-494..
8. KAWASHIMA A, SANDLER C M, ERNST R D, et al. Renal inflammatory disease: the current role of CT[J]. Crit Rev Diagn Imaging,1997,38:369-415..
9. 王海燕主編.腎臟病學[M].第2版.北京:人民衛生出版社,1987:825-827..

West China Medical Journal

Retrospective Analysis of Multidetector Spiral CT Contrast Enhanced Scan for Chronic Pyelonephritits

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