Kumar Ranjan, Kumar Airon Raj, Mittal Amit, Singal Rikki, Sharma Kamal, Singal Samita
Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana (Distt -Ambala), Haryana, India.
Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.
Maedica (Bucur). 2017 Jun;12(2):87-94.
(1) To study the role of multidetector computed tomography in patients with haematuria. (2) To correlate multidetector computed tomography findings with clinical outcome/laboratory findings/FNAC and/or operative findings (wherever performed).
The present study was carried out in the Department of Radiodiagnosis, M.M. Institute of Medical Sciences and Research, Mullana, Ambala, from April 2014 to 2016. Fifty patients with complaint of haematuria, referred from various wards and outpatient departments of this institution, were included. Multidetector computed tomography was performed in ultrasonography positive cases, in symptomatic patients with negative ultrasonography scans and in those with suboptimal ultrasonography scans. The equipment used in our study was a HD 11 XE (Philips medical systems) ultrasound unit with convex and linear probes and a 128 slice Multidetector CT (Philips Ingenuity).
Maximum number of patients (30%) in the 51-60 years age group with a male preponderance. The prevalence of malignancy in patients with haematuria in this study was 28% which included bladder urothelial carcinoma (18%), renal cell carcinoma (6%), UTUC (4%), prostatic carcinoma (2%) and one case of TCC which turned out to be non-Hodgkin's lymphoma on histopathology. Calculi were more prevalent in the younger age group and overall constituted 20% of the causes of haematuria. Other causes of haematuria detected on multidetector computed tomography were pyelonephritis, renal trauma (grade V renal injury), bladder diverticulum, benign prostatic hyperplasia and cystitis.
Multidetector computed tomography by using its multiplanar and 3D capabilities is highly accurate and specific in detecting the causes of haematuria. It can demonstrate the exact site of involvement in very high percent of cases. In addition to haematuria, multidetector computed tomography can detect various associated and incidental findings which may not be suspected clinically.
（1）研究多排螺旋计算机断层扫描在血尿患者中的作用。（2）将多排螺旋计算机断层扫描结果与临床结局/实验室检查结果/细针穿刺活检及/或手术结果（若已进行手术）相关联。
本研究于2014年4月至2016年在安巴拉穆拉纳MM医学科学与研究学院放射诊断科开展。纳入了50例因血尿前来就诊的患者，这些患者来自该机构的各个病房和门诊科室。对超声检查阳性的病例、超声扫描阴性的有症状患者以及超声扫描结果欠佳的患者进行了多排螺旋计算机断层扫描。我们研究中使用的设备是一台配备凸阵探头和线阵探头的HD 11 XE（飞利浦医疗系统）超声仪以及一台128层多排螺旋CT（飞利浦Ingenuity）。
51 - 60岁年龄组的患者数量最多（占30%），男性居多。本研究中血尿患者的恶性肿瘤患病率为28%，其中包括膀胱尿路上皮癌（18%）、肾细胞癌（6%）、上尿路尿路上皮癌（4%）、前列腺癌（2%）以及1例经组织病理学检查确诊为非霍奇金淋巴瘤的移行细胞癌。结石在较年轻年龄组中更为常见，总体占血尿病因的20%。多排螺旋计算机断层扫描检测到的其他血尿病因包括肾盂肾炎、肾外伤（Ⅴ级肾损伤）、膀胱憩室、良性前列腺增生和膀胱炎。
多排螺旋计算机断层扫描利用其多平面和三维功能，在检测血尿病因方面具有高度准确性和特异性。在极高比例的病例中，它能够显示确切的受累部位。除血尿外，多排螺旋计算机断层扫描还能检测出各种临床上可能未被怀疑的相关和偶然发现。
