Juri Hiroshi, Tsuboyama Takahiro, Koyama Mitsuhiro, Yamamoto Kiyohito, Nakai Go, Nakamoto Atsushi, Yamamoto Kazuhiro, Azuma Haruhito, Narumi Yoshifumi
Department of Radiology, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki, Osaka, Japan.
Department of Radiology, Osaka University School of Medicine, 2-15 Yamadaoka, Suita, Osaka, Japan.
PLoS One. 2017 Apr 6;12(4):e0174800. doi: 10.1371/journal.pone.0174800. eCollection 2017.
To prospectively evaluate the ability of CT urography with a low-dose multi-phasic excretory phase for opacification of the urinary system.
Thirty-two patients underwent CT urography with low-dose multi-phasic s using adaptive iterative dose reduction 3D acquired at 5-, 10-, and 15-minute delays. Opacification scores of the upper urinary tracts and the urinary bladder were assigned for each excretory phase by two radiologists, who recorded whether adequate (>75%) or complete (100%) opacification of the upper urinary tract and urinary bladder was achieved in each patient. Adequate and complete opacification rates of the upper urinary tracts and the urinary bladder were compared among three excretory phases and among combined multi-phasic excretory phases using Cochran's Q test.
There was no significant difference among three excretory phases with 5-, 10-, and 15-minute delays in adequate (56.3, 43.8, and 63.5%, respectively; P = 0.174) and complete opacification rates (9.3, 15.6, and 18.7%, respectively; P = 0.417) of the upper urinary tracts. Combined tri-phasic excretory phases significantly improved adequate and complete opacification rates to 84.4% and 43.8%, respectively (P = 0.002). In contrast, there were significant differences among three excretory phases for the rate of adequate (31.3, 84.4, and 93.8%, respectively; P<0.001) and complete opacification (21.9, 53.1, and 81.3%, respectively; P<0.001) of the urinary bladder. Multi-phasic excretory phases did not improve these rates because opacification was always better with a longer delay.
Although multi-phasic acquisition of excretory phases is effective at improving opacification of the upper urinary tracts, complete opacification is difficult even with tri-phasic acquisition.
前瞻性评估低剂量多期排泄期CT尿路造影对泌尿系统显影的能力。
32例患者接受了低剂量多期CT尿路造影，采用自适应迭代剂量降低3D技术，分别在延迟5分钟、10分钟和15分钟时采集图像。两名放射科医生为每个排泄期的上尿路和膀胱分配显影评分，并记录每位患者上尿路和膀胱是否实现了充分（>75%）或完全（100%）显影。使用 Cochr an Q检验比较三个排泄期以及联合多期排泄期上尿路和膀胱的充分显影率和完全显影率。
延迟5分钟、10分钟和15分钟的三个排泄期在上尿路的充分显影率（分别为56.3%、43.8%和63.5%；P = 0.174）和完全显影率（分别为9.3%、15.6%和18.7%；P = 0.417）方面无显著差异。联合三期排泄期显著提高了充分显影率和完全显影率，分别达到84.4%和43.8%（P = 0.002）。相比之下，三个排泄期在膀胱的充分显影率（分别为31.3%、84.4%和93.8%；P<0.001）和完全显影率（分别为21.9%、53.1%和81.3%；P<0.001）方面存在显著差异。多期排泄期并未提高这些比率，因为延迟时间越长显影总是越好。
尽管多期采集排泄期对改善上尿路显影有效，但即使采用三期采集也难以实现完全显影。
