CAJ | 학술논문

目的：探讨IVP输尿管显影不良后进行低剂量MSCT扫描的应用价值。方法：IVP输尿管显影不良后，立即或择期进行低剂量MSCT扫描。根据患者的体质情况（如腰围、体重），制定了三组低剂量MSCT扫描参数，不同体质的患者用相应不同扫描参数进行低剂量MSCT扫描，体质瘦小者用低KV、低MA进行低剂量MSCT扫描。统计42例用低剂量MSCT扫描的患者资料，总结其低剂量扫描后减少X线辐射剂量；又统计低剂量MSCT扫描后对输尿管、肾脏疾病的诊断价值。结果：综合分析IVP与低剂量扫描MSCT图像，结果显示为结石是输尿管和/或肾脏结石的首发原因，占64.3%。CT可以发现IVP不能显示的小结石。输尿管显影不良的原因中，输尿管、肾脏先天性疾病所占比率为29.4%。低剂量MSCT扫描可以解决IVP输尿管显影不良的原因。另外低剂量MSCT扫描时，MAS总量一般在1200~3000 MAS，平均减少2100 MAS；CTDI值平均减少59.7%，相当于患者减少210次胸部DR片检查的辐射剂量。结论：IVP输尿管显影不良时，通过低剂量MSCT扫描，减少患者X线辐射剂量，解决了IVP输尿管显影不良的原因，为临床提供正确诊断。
목적：탐토IVP수뇨관현영불량후진행저제량MSCT소묘적응용개치。방법：IVP수뇨관현영불량후，립즉혹택기진행저제량MSCT소묘。근거환자적체질정황（여요위、체중），제정료삼조저제량MSCT소묘삼수，불동체질적환자용상응불동소묘삼수진행저제량MSCT소묘，체질수소자용저KV、저MA진행저제량MSCT소묘。통계42례용저제량MSCT소묘적환자자료，총결기저제량소묘후감소X선복사제량；우통계저제량MSCT소묘후대수뇨관、신장질병적진단개치。결과：종합분석IVP여저제량소묘MSCT도상，결과현시위결석시수뇨관화/혹신장결석적수발원인，점64.3%。CT가이발현IVP불능현시적소결석。수뇨관현영불량적원인중，수뇨관、신장선천성질병소점비솔위29.4%。저제량MSCT소묘가이해결IVP수뇨관현영불량적원인。령외저제량MSCT소묘시，MAS총량일반재1200~3000 MAS，평균감소2100 MAS；CTDI치평균감소59.7%，상당우환자감소210차흉부DR편검사적복사제량。결론：IVP수뇨관현영불량시，통과저제량MSCT소묘，감소환자X선복사제량，해결료IVP수뇨관현영불량적원인，위림상제공정학진단。
To investigate the application value of low dose MSCT scanning after IVP ureteral adverse development.Method:After IVP ureteral adverse development,low dose MSCT scanning was performed immediately or elective.According to the physical condition of patients(such as waist circumference,body weight),the low dose MSCT scanning parameters of the three groups were formulated,different physical patients were carried out low dose MSCT scanning using different scan parameters,physique thin person were carried out low dose MSCT scanning using low KV, low MA.The data of 42 patients with low dose MSCT scanning were statistical analyzed,the X-ray radiation dose reduction after low dose MSCT scanning was summarized,the value in diagnosis of ureter,renal disease of low dose MSCT scanning were statistical analyzed.Result:The comprehensive analysis of IVP and low dose MSCT scan image,results showed that stone was the first reason for calculus of ureter and/or kidney stones,accounted for 64.3%.CT could be found that IVP couldn’t display calculi.The reason of ureteral adverse development of kidney,ureter,congenital diseases, accounting for 29.4%.Low dose MSCT scanning could solve the causes of adverse development of IVP ureter.In addition to low dose MSCT scanning,the total MAS in general 1200-3000 MAS,an average reduction was 2100 MAS.CTDI value reduced by 59.7%on average,equivalent to reduce 210 times in patients with chest DR ray examination of radiation dose. Conclusion:IVP ureteral development is poor,through low dose MSCT scanning,reduce patient X-ray dose,solve the reason of IVP ureteral adverse development,provide correct diagnosis for clinical.