CAJ | 학술논문

目的：探讨64层容积 CT 尿路造影(CTU)延迟扫描在泌尿系统疾病诊断中的应用价值。方法收集临床资料完整的泌尿系统疾病141例,均行 CTU 个体化延迟扫描。由2名有经验的放射科医师(A、B)采用盲法分别对 CTU 延迟扫描前后的图像进行容积再现、最大密度投影、多平面重建及曲面重组等后处理分析、诊断。记录每例患者延迟扫描前后累计剂量长度乘积(DLP),并计算有效辐射剂量。结果141例泌尿系统疾病中,泌尿系统先天畸形42例,输尿管炎性病变11例,输尿管癌22例,膀胱肿瘤23例,邻近组织病变累及输尿管21例,泌尿系统瘘8例,尿道改流术后14例。A 医师 CTU 延迟扫描前后诊断准确率分别为36.17%(51/141)、90.07%(127/141),B 医师 CTU 延迟扫描前后诊断准确率分别为36.88%(52/141)、88.65%(125/141),A、B 医师 CTU 延迟扫描前后的诊断准确率差异均有统计学意义(P <0.05)。延迟扫描平均增加辐射剂量约5.78 mSv。结论延迟扫描能明显提高 CTU 对泌尿系统疾病的诊断准确率,在泌尿系统疾病的诊治中具有重要应用价值,延迟扫描增加了患者的辐射剂量,应注意合理规范延迟扫描适应证、扫描次数及范围。
목적：탐토64층용적 CT 뇨로조영(CTU)연지소묘재비뇨계통질병진단중적응용개치。방법수집림상자료완정적비뇨계통질병141례,균행 CTU 개체화연지소묘。유2명유경험적방사과의사(A、B)채용맹법분별대 CTU 연지소묘전후적도상진행용적재현、최대밀도투영、다평면중건급곡면중조등후처리분석、진단。기록매례환자연지소묘전후루계제량장도승적(DLP),병계산유효복사제량。결과141례비뇨계통질병중,비뇨계통선천기형42례,수뇨관염성병변11례,수뇨관암22례,방광종류23례,린근조직병변루급수뇨관21례,비뇨계통루8례,뇨도개류술후14례。A 의사 CTU 연지소묘전후진단준학솔분별위36.17%(51/141)、90.07%(127/141),B 의사 CTU 연지소묘전후진단준학솔분별위36.88%(52/141)、88.65%(125/141),A、B 의사 CTU 연지소묘전후적진단준학솔차이균유통계학의의(P <0.05)。연지소묘평균증가복사제량약5.78 mSv。결론연지소묘능명현제고 CTU 대비뇨계통질병적진단준학솔,재비뇨계통질병적진치중구유중요응용개치,연지소묘증가료환자적복사제량,응주의합리규범연지소묘괄응증、소묘차수급범위。
Objective To explore the application value of 64-slice volume computer tomography urography(CTU)delayed scan-ning in diagnosing the urinary diseases.Methods 141 patients with different urinary diseases underwent the CTU individualized de-layed scanning,all the clinical information were detailed.Two experienced radiologists(A,B)separately utilized blind method to ana-lyze and diagnose the scanned images before and after the CTU delayed scanning with the reconstruction techniques,including the volume rendering(VR),maximum intensity projection(MIP),multiplanar reconstruction(MPR),and curve planar reconstruction (CPR).They also recorded the accumulated dose length produce(DLP)of every case before and after the CTU delayed scanning,and calculated the effective radiation dose.Results Among 141 urinary diseases cases,there were urinary system congenital deformities in 42 cases,ureteral inflammatory disease in 1 1 cases,primary uretal cancer in 22 cases,bladder tumor in 23 cases,the ureter in-volved by adjacent tissue lesions in 21 cases,ureter fistula in 8 cases,urinary diversion in 14 cases.The diagnostic accuracy of radiolo-gist A was 36.1 7%(5 1/141)and 90.07% (127/141)for without and with the CTU delayed scanning respectively.The diagnostic ac-curacy of radiologist B was 36.88%(52/141)and 88.65% (125/141)for without and with the CTU delayed scanning respectively. The differences of the diagnostic accurancy between radiologist A and radiologist B for without and with the delayed scanning had statistical significance separately(P<0.05).The average increased radiation dose was 5.78 mSv with the delayed scanning.Conclu-sion Delayed scanning can distinctly improve the CTU diagnostic accuracy of the urinary diseases.It has a high value of practical application in diagnosing the urinary diseases.Tthe delayed scanning will increase the radiation dose to the patients.As a result,the indications,frequency and proportion for the utilization of the delayed scanning should be carefully managed.