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膀胱输尿管反流:通过膀胱容量分级直接放射性核素膀胱造影进行评估。

Vesicoureteric reflux: Evaluation by bladder volume graded direct radionuclide cystogram.

作者信息

Agrawal Vikesh, Rangarajan Venkatesh, Kamath Tejaswini, Borwankar S S

机构信息

Department of Pediatric Surgery, Seth G S Medical College and KEM Hospital, Mumbai, India.

出版信息

J Indian Assoc Pediatr Surg. 2009 Jan;14(1):15-8. doi: 10.4103/0971-9261.45360.

DOI:10.4103/0971-9261.45360
PMID:20177437
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2809455/
Abstract

AIM

Evaluation of vesicoureteric reflux (VUR) in children by bladder volume graded direct radionuclide cystogram (BVG DRC). This technique allows detection of VUR at different bladder volume grades.

MATERIALS AND METHODS

In this prospective study, 33 patients (66 renal units) with suspected vesicoureteric reflux were subjected to a voiding cystourethrogram (VCUG) and BVG DRC. The patients were assessed further with radioisotope renal scans for renal cortical scars.

RESULTS

Twenty-two patients and 36 renal units were found to have VUR in either of the reflux studies. A VCUG was able to detect 20 units (55.50%) and a BVG DRC was able to detect 35 units (97.2%). A VCUG had a test accuracy of 77.8% and a BVG DRC had a test accuracy of 98.6%. There was a positive correlation between bladder volume grades and scarring on a DMSA scan.

CONCLUSIONS

Like a conventional DRC, BVG DRC is a sensitive and an accurate test. It gives additional information on the reflux phenomenon with respect to bladder filling. The bladder volume graded technique is better than conventional DRC for grading of VUR.

摘要

目的

通过膀胱容量分级直接放射性核素膀胱造影(BVG DRC)评估儿童膀胱输尿管反流(VUR)。该技术可在不同膀胱容量分级下检测VUR。

材料与方法

在这项前瞻性研究中,33例疑似膀胱输尿管反流的患者(66个肾单位)接受了排尿膀胱尿道造影(VCUG)和BVG DRC检查。患者还接受了放射性核素肾扫描以评估肾皮质瘢痕。

结果

在两项反流研究中,22例患者和36个肾单位被发现存在VUR。VCUG能检测出20个单位(55.50%),BVG DRC能检测出35个单位(97.2%)。VCUG的检测准确率为77.8%,BVG DRC的检测准确率为98.6%。DMSA扫描显示膀胱容量分级与瘢痕形成之间存在正相关。

结论

与传统DRC一样,BVG DRC是一种敏感且准确的检测方法。它提供了关于膀胱充盈时反流现象的额外信息。膀胱容量分级技术在VUR分级方面优于传统DRC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4367/2809455/b93c425962c3/JIAPS-14-15-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4367/2809455/cd0ad09cd858/JIAPS-14-15-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4367/2809455/b93c425962c3/JIAPS-14-15-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4367/2809455/cd0ad09cd858/JIAPS-14-15-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4367/2809455/b93c425962c3/JIAPS-14-15-g002.jpg

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本文引用的文献

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Ann Nucl Med. 2003 Oct;17(7):549-53. doi: 10.1007/BF03006667.
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Vesico-ureteric reflux in the young infant with follow-up direct radionuclide cystograms: the medical and surgical outcome at 5 years old.婴儿期膀胱输尿管反流的直接放射性核素膀胱造影随访:5岁时的内科及外科治疗结果
BJU Int. 2002 Nov;90(7):721-4. doi: 10.1046/j.1464-410x.2002.03012.x.
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Direct comparison of radiology and nuclear medicine cystograms in young infants with vesico-ureteric reflux.
对患有膀胱输尿管反流的幼儿进行放射学与核医学膀胱造影的直接比较。
BJU Int. 2001 Jan;87(1):93-7. doi: 10.1046/j.1464-410x.2001.00997.x.
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Pediatr Nephrol. 2000 Jan;14(1):39-41. doi: 10.1007/s004670050010.
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J Urol. 1999 Sep;162(3 Pt 2):1193-6. doi: 10.1016/S0022-5347(01)68128-X.
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Pediatr Nephrol. 1995 Dec;9(6):715-7. doi: 10.1007/BF00868720.
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J Urol. 1982 Sep;128(3):550-3. doi: 10.1016/s0022-5347(17)53039-6.
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