CAJ | 학술논문

目的：：探讨CT平扫能否有助于对单侧输尿管梗阻患者急、慢性输尿管梗阻的鉴别。方法：回顾性分析2010年7月至2014年6月本院105例患者的中下腹＋盆腔CT平扫资料，其中急性单侧输尿管梗阻、慢性单侧输尿管梗阻各35例，无输尿管梗阻35例作为对照组。分析比较急、慢性输尿管梗阻的继发CT平扫征象，测量上述病例双肾实质(上极、中份、下极)平扫CT值，比较其差异。结果：70例单侧急、慢性输尿管梗阻患者继发CT平扫征象有：肾周条带状改变、肾集合系统和/或输尿管积水扩张。肾周条带状改变在急性梗阻患者出现率较慢性梗阻患者高，前者为85.71％(30/35)，后者为5.71％(2/35)。急性梗阻患者肾集合系统和/或输尿管积水扩张一般为无或轻￣中度扩张，而慢性梗阻患者均出现不同程度的积水、扩张，以中度为著(25/35)。105例患者双肾实质平扫CT值测量结果经统计分析显示：急性输尿管梗阻侧肾实质密度明显低于慢性输尿管梗阻侧、同一病例对侧正常肾实质以及对照组肾实质密度(P<0.05)，对照组及慢性输尿管梗阻患者双肾实质密度无明显差异(P>0.05)。结论：单侧急、慢性输尿管梗阻CT平扫继发征象有一定特点，联合CT平扫双肾实质密度差这个客观的、可测量参数，有助于区分急、慢性输尿管梗阻。
목적：：탐토CT평소능부유조우대단측수뇨관경조환자급、만성수뇨관경조적감별。방법：회고성분석2010년7월지2014년6월본원105례환자적중하복＋분강CT평소자료，기중급성단측수뇨관경조、만성단측수뇨관경조각35례，무수뇨관경조35례작위대조조。분석비교급、만성수뇨관경조적계발CT평소정상，측량상술병례쌍신실질(상겁、중빈、하겁)평소CT치，비교기차이。결과：70례단측급、만성수뇨관경조환자계발CT평소정상유：신주조대상개변、신집합계통화/혹수뇨관적수확장。신주조대상개변재급성경조환자출현솔교만성경조환자고，전자위85.71％(30/35)，후자위5.71％(2/35)。급성경조환자신집합계통화/혹수뇨관적수확장일반위무혹경￣중도확장，이만성경조환자균출현불동정도적적수、확장，이중도위저(25/35)。105례환자쌍신실질평소CT치측량결과경통계분석현시：급성수뇨관경조측신실질밀도명현저우만성수뇨관경조측、동일병례대측정상신실질이급대조조신실질밀도(P<0.05)，대조조급만성수뇨관경조환자쌍신실질밀도무명현차이(P>0.05)。결론：단측급、만성수뇨관경조CT평소계발정상유일정특점，연합CT평소쌍신실질밀도차저개객관적、가측량삼수，유조우구분급、만성수뇨관경조。
Objective:To investigate whether CT plain scanning may help differentiate acute from chronic ureteral obstruction.Methods:Data about CT plain scanning of midle to lower abdomen and the pelvic cavity from 105 patients between July 2010 and June 2014 were reviewed. These patients included 35 cases of acute and 35 of chronic ureteral obstruction. A cohort of 35 patients without ureteral obstruction were assigned as the control group. We compared the secondary signs of ureteral obstruction on plain scanning and the mean CT value of both kidneys ( averaged among the upper, middle and lower poles of kidney) between patients with acute and chronic ureteral obstruction.Results:Among the 70 cases of acute or chronic unilateral ureteral obstruction, the secondary signs of the obstruction on CT plain scanning included perinephric stranding, and dilation of the renal collective system and/or ureter. Perinephric stranding was observed more in the acute than in chronic obstruction cases [30 (85.71%) vs 2 (5.71%)]. Dilation of renal collective system and/or ureter was not found or mild to moderate in severity among acute obstruction cases, in contrast to a wide range of severity but most predominated by moderate disease ( 25 of 35) in the chronic cases. Statistical analysis of the CT values in 105 patients who underwent CT plain scanning of the both kidney parenchyma showed that the ipsilateral kidney density in acute ureteral obstruction was signficantly lower than that in chronic obstruction, and also lower than the contralateral kidney density in a same patient, or the kidney density in the control group (all P<0.05). There was no statistically signi cant attenuation difference between right and left kidneys in the control group and chronic group ( P>0.05) . Conclusion:The secondary signs of unilateral ureteral obstruction on CT plain scanning show certain features between acute and chronic cases. Attenuation difference as an objective, measurable indicator may help differentiating acute from chronic ureteral obstruction.