McTavish Jeffrey D, Jinzaki Masahiro, Zou Kelly H, Nawfel Richard D, Silverman Stuart G
Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
Radiology. 2002 Dec;225(3):783-90. doi: 10.1148/radiol.2253011515.
To evaluate several protocols for depiction of the urinary collecting system with multi-detector row computed tomographic (CT) urography.
Fifty-one patients with hematuria or a suspicious renal mass underwent CT urography, during which thinly collimated (1-mm) pyelographic phase scanning was performed 8-10 minutes after contrast medium administration. Patients were examined while prone only (n = 17) and while both prone and supine (n = 17) after a 250-mL infusion of normal saline. Each collecting system and ureter was divided into six segments that were assigned opacification scores. All acquisition techniques were compared, and the highest-scoring technique was compared with that in 17 patients who underwent conventional intravenous urography (IVU). Three reconstruction techniques (transverse, coronal, and maximal intensity projection) were also compared. Stratified analysis was performed with the paired two-tailed Student t test to compare opacification scores for both the acquisition techniques and display methods, both individually and in all possible combinations.
CT urography with supplemental saline administration, performed with the patient prone or supine, significantly improved mean opacification scores in the distal ureters (right, P =.004; left, P =.006). With this technique, CT urography produced a mean opacification score that was not significantly different from that with IVU in 11 of 12 segments and was significantly better than that with IVU in one of 12 segments (lower left ureter). Mean opacification scores obtained with transverse or coronal displays were equal to or higher than those obtained with maximum intensity projection reconstructions in all segments.
CT urography with a multi-detector row scanner and supplemental infusion of normal saline reliably displays the opacified urinary collecting system.
评估多种采用多排探测器计算机断层扫描（CT）尿路造影术描绘泌尿系统收集系统的方案。
51例血尿或可疑肾肿块患者接受了CT尿路造影，在注射造影剂后8 - 10分钟进行薄层（1毫米）肾盂造影期扫描。患者仅在俯卧位时接受检查（n = 17），以及在输注250毫升生理盐水后在俯卧位和仰卧位均接受检查（n = 17）。每个收集系统和输尿管被分为六个节段，并赋予显影评分。比较所有采集技术，将得分最高的技术与17例接受传统静脉尿路造影（IVU）的患者的技术进行比较。还比较了三种重建技术（横轴位、冠状位和最大密度投影）。采用配对双尾Student t检验进行分层分析，以比较采集技术和显示方法的显影评分，包括单独比较以及所有可能组合的比较。
在患者俯卧或仰卧位时进行补充生理盐水的CT尿路造影，显著提高了输尿管远端的平均显影评分（右侧，P =.004；左侧，P =.006）。采用该技术，CT尿路造影在12个节段中的11个节段产生的平均显影评分与IVU无显著差异，在12个节段中的1个节段（左输尿管下段）显著优于IVU。在所有节段中，横轴位或冠状位显示获得的平均显影评分等于或高于最大密度投影重建获得的评分。
使用多排探测器扫描仪并补充输注生理盐水的CT尿路造影能够可靠地显示显影的泌尿系统收集系统。
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