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目的:探讨静脉肾盂造影(IVP)联合IVP后泌尿系三维重建CT在诊断小儿先天性重复肾畸形中的临床应用价值。方法:40例经术后病理证实的小儿先天性泌尿系重复肾畸形患者,在术前1周内分别行常规泌尿系超声检查、IVP及IVP后CT扫描检查,CT图像后处理采用曲面重建(CPR)、多平面容积重现(MPR)、最大密度投影(MIP)、容积再现技术(VRT)等方法,比较三种成像方法的诊断准确性及对重复肾畸形分型的价值。结果:超声检查确诊31例,诊断准确率77.5%;IVP检查确诊26例,诊断准确率65.0%;IVP联合IVP后CT检查确诊38例,诊断准确率95.0%。而在对已确诊的40例重复肾患者分型中,超声检查分型正确率为70%;IVP分型正确率为55.0%;IVP联合IVP后泌尿系CT检查分型准确率达92.5%;IVP联合IVP后三维重建CT诊断准确率及分型准确率高于超声检查及单纯IVP检查(P<0.05)。结论:IVP联合IVP后三维重建CT技术对小儿泌尿系重复肾畸形有较好的诊断准确性及分型准确性,可指导临床治疗方式。
Objective: To investigate the clinical value of intravenous pyelography (IVP) combined with IVP urography three-dimensional reconstruction CT in the diagnosis of congenital renal abnormalities in children. Methods: Forty patients with congenital urinary tract recurrent renal abnormalities confirmed by postoperative pathology were examined by routine urography, IVP and IVP postoperative CT scan. The CT images were reconstructed by surface reconstruction CPR, MPR, MIP and VRT were used to compare the diagnostic accuracy of the three imaging methods and the classification of repeated nephronsia. Results: Thirty-one cases were diagnosed by ultrasonography with a diagnostic accuracy of 77.5%. 26 cases were diagnosed by IVP and the diagnostic accuracy was 65.0%. 38 cases were diagnosed by IVP combined with IVP and the diagnostic accuracy was 95.0%. However, in the 40 cases of confirmed repeat renal disease, the accuracy rate of ultrasound examination was 70%, the accuracy rate of IVP classification was 55.0%, and the accuracy rate of urinary CT examination after IVP and IVP was 92.5%. IVP combined with IVP after three-dimensional reconstruction CT diagnostic accuracy and classification accuracy rate higher than ultrasound and simple IVP examination (P <0.05). Conclusion: IVP combined with IVP after three-dimensional reconstruction of CT in children with recurrent urinary tract renal deformity has a good diagnostic accuracy and accuracy of typing, can guide the clinical treatment.