平扫 CT 显示肾髓质高强化：呋塞米的应用有何影响？
Visualization of renal medullary hyperattenuation at unenhanced CT: what is the effect of furosemide administration?
机构信息
Department of Radiology, University of California San Francisco, 505 Parnassus Ave, Box 0628, C-372C, San Francisco, CA 94143-0628, USA.
出版信息
Radiology. 2010 May;255(2):495-500. doi: 10.1148/radiol.10091769.
PURPOSE
To retrospectively investigate the effects of furosemide on the visualization of renal medullary hyperattenuation at unenhanced computed tomography (CT).
MATERIALS AND METHODS
This retrospective single-institution study was HIPAA compliant and approved by the institutional review board; requirement for informed consent was waived. This study identified 289 consecutive patients (152 men, 137 women; mean age, 59 years) without ureteral obstruction who underwent unenhanced scanning as part of CT urography; of these, 178 patients did not receive intravenous furosemide prior to imaging and 111 did. The presence of renal medullary hyperattenuation, renal stones, and bladder urine attenuation levels were recorded and compared between patients who did not receive furosemide prior to imaging and those who did by using the chi(2) and unpaired Student t tests. A multiple logistic regression model was used to evaluate independent predictors of visualization of renal medullary hyperattenuation.
RESULTS
Renal medullary hyperattenuation was seen less commonly in patients who received furosemide (27 of 111, 24%) than in those who did not receive furosemide prior to imaging (79 of 178, 44%, P = .001). Bladder urine attenuation was lower in patients who received furosemide (-0.1 HU) compared with those who did not (6.4 HU, P < .001). A multiple logistic regression model revealed independent associations between the visualization of renal medullary hyperattenuation and the absence of furosemide administration (P = .002), younger age (P < .001), and presence of renal stones (P = .047).
CONCLUSION
Furosemide administration prior to unenhanced CT is associated with decreased visualization of renal medullary hyperattenuation.
目的
回顾性研究呋塞米对平扫 CT 上肾髓质高强化的显示效果。
材料与方法
本回顾性单机构研究符合 HIPAA 规定，并获得了机构审查委员会的批准；豁免了知情同意要求。本研究共纳入 289 例连续患者（男 152 例，女 137 例；平均年龄 59 岁），这些患者均因行 CT 尿路造影而接受平扫，其中 178 例患者在成像前未接受静脉注射呋塞米，111 例患者接受了该治疗。记录并比较了两组患者（成像前未接受呋塞米治疗组和接受呋塞米治疗组）的肾髓质高强化、肾结石和膀胱尿液衰减水平，采用卡方检验和独立样本 t 检验进行比较。采用多因素逻辑回归模型评估肾髓质高强化显示的独立预测因素。
结果
接受呋塞米治疗的患者中肾髓质高强化的显示频率较低（111 例中的 27 例，24%），低于未接受呋塞米治疗的患者（178 例中的 79 例，44%，P =.001）。接受呋塞米治疗的患者的膀胱尿液衰减值较低（-0.1 HU），低于未接受呋塞米治疗的患者（6.4 HU，P <.001）。多因素逻辑回归模型显示，肾髓质高强化的显示与未接受呋塞米治疗（P =.002）、年龄较小（P <.001）和肾结石的存在（P =.047）存在独立关联。
结论
平扫 CT 前给予呋塞米与肾髓质高强化显示减少相关。
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