Xu Yan, Lyu Jian-Lin
Department of Urology, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu 210046, China.
Chronic Dis Transl Med. 2016 Apr 6;2(1):42-47. doi: 10.1016/j.cdtm.2016.02.001. eCollection 2016 Mar.
The aim of our study was to determine if there is any advantage of three-dimensional helical computed tomography (3D-HCT) over intravenous urogram (IVU) for the retrograde flexible ureteronephroscopy in the treatment of lower pole calyx stones.
From June 2012 to January 2014, a total of 52 cases of lower pole renal stones underwent retrograde intrarenal surgery (RIRS) in our center. All patients underwent a preoperative IVU and three-dimensional helical computed tomography urography (3D-CTU) program to define the collecting system anatomy, manly concerning the following lower pole features; infundibu-lopelvic angle (IPA), infundibular length (IL), and infundibular width (IW). The examinations were performed in the same center of reference with a standardized method and with 3D-HCT Siemens Somaton Plus equipment. The measurements were performed by the same researcher, using a ruler and a square.
Based on clinical threshold difference of the anatomic factors on an IVU image to compare the difference between an IVU image and a 3D-CT image of 52 patients, the IPA was <30° when measured on intravenous pyelography (IVP) for 21 patients. We found that with the IPA of <30° measured with IVP only 19% (4/21) were correctly classified in the same size category using 3D-HCT, whereas 81% (17/21) were upgraded to 40-50° on 3D-CT. This difference was significant between IVP and 3D-HCT.
3D-HCT has advantages over IVU when analyzing the morphometric and the morphological features of kidney lower pole spatial anatomy for the retrograde flexible ureteronephroscopy in the treatment of lower pole calyx stones.
我们研究的目的是确定在逆行软性输尿管肾镜治疗下极肾盏结石时，三维螺旋计算机断层扫描（3D-HCT）相对于静脉肾盂造影（IVU）是否具有任何优势。
2012年6月至2014年1月，我院中心共有52例下极肾结石患者接受了逆行肾内手术（RIRS）。所有患者均接受了术前IVU和三维螺旋计算机断层扫描尿路造影（3D-CTU）检查，以明确集合系统的解剖结构，主要关注以下下极特征：漏斗肾盂角（IPA）、漏斗长度（IL）和漏斗宽度（IW）。检查在同一参考中心采用标准化方法，使用3D-HCT西门子Somaton Plus设备进行。测量由同一名研究人员使用尺子和直角尺进行。
基于IVU图像上解剖因素的临床阈值差异，比较52例患者的IVU图像和3D-CT图像之间的差异，静脉肾盂造影（IVP）测量时IPA＜30°的患者有21例。我们发现，IVP测量IPA＜30°时，使用3D-HCT只有19%（4/21）被正确分类到相同大小类别，而81%（17/21）在3D-CT上被提升到40-50°。IVP和3D-HCT之间的这种差异具有统计学意义。
在分析肾下极空间解剖结构的形态计量学和形态学特征以用于逆行软性输尿管肾镜治疗下极肾盏结石时，3D-HCT比IVU具有优势。
