O'Malley M E, Hahn P F, Yoder I C, Gazelle G S, McGovern F J, Mueller P R
Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA. martin.o'
Clin Radiol. 2003 Apr;58(4):294-300. doi: 10.1016/s0009-9260(02)00464-6.
To compare excretory phase, helical computed tomography (CT) with intravenous (IV) urography for evaluation of the urinary tract in patients with painless haematuria.
Ninety-one out-patients had IV urography followed by helical CT limited to the urinary tract. Both IV urograms and CT images were evaluated for abnormalities of the urinary tract in a blinded, prospective manner. The clinical significance of abnormalities was scored subjectively and receiver operator characteristic curve analysis was performed.
In 69 of 91 patients (76%), no cause of haematuria was identified. In 22 of 91 patients (24%), the cause of haematuria was identified as follows: transitional cell cancer of the bladder (n=15), urinary tract stones (n=3), cystitis (n=2), haemorrhagic pyelitis (n=1) and benign ureteral stricture (n=1). With IV urography, there were 15 true-positive, seven false-negative and three false-positive interpretations. With CT, there were 18 true-positive, four false-negative and two false-positive interpretations. There was no significant difference between IV and CT urography for the significance of the positive interpretations (n=0.47).
Excretory phase CT urography was comparable with IV urography for evaluation of the urinary tract in patients with painless haematuria. However, the study population did not include any upper tract cancers.
比较排泄期螺旋计算机断层扫描（CT）与静脉肾盂造影（IVU）对无痛性血尿患者尿路的评估情况。
91例门诊患者先进行静脉肾盂造影，随后进行限于尿路的螺旋CT检查。静脉肾盂造影图像和CT图像均采用盲法、前瞻性方式评估尿路异常情况。对异常情况的临床意义进行主观评分，并进行受试者操作特征曲线分析。
91例患者中有69例（76%）未发现血尿原因。91例患者中有22例（24%）的血尿原因如下：膀胱移行细胞癌（n = 15）、尿路结石（n = 3）、膀胱炎（n = 2）、出血性肾盂炎（n = 1）和良性输尿管狭窄（n = 1）。静脉肾盂造影检查有15例假阳性、7例假阴性和3例假阳性解读。CT检查有18例假阳性、4例假阴性和2例假阳性解读。静脉肾盂造影和CT检查在阳性解读的意义方面无显著差异（n = 0.47）。
排泄期CT尿路造影在评估无痛性血尿患者尿路方面与静脉肾盂造影相当。然而，研究人群中未包括任何上尿路癌症患者。
