Segasothy M, Abdul Samad S, Zulfiqar A, Shaariah W, Morad Z, Prasad Menon S
Department of Medicine, University Kebangsaan, Kuala Lumpur, Malaysia.
Nephron. 1994;66(1):62-6. doi: 10.1159/000187767.
Computed tomography (CT) and ultrasonography (US) were performed in 40 patients who had consumed excessive quantities of analgesics (> 1 kg) to compare their value in the diagnosis of analgesic nephropathy (AN). The computed tomography and sonographic features were renal papillary calcifications. Renal papillary necrosis (RPN) was documented in 20 of 40 patients by US and in 14 of 40 patients by CT. In 11 patients, both US and CT were positive. In 9 patients, US was positive whilst CT was negative. In 3 patients, CT was positive whilst US was negative. Prevalence of RPN was 50% using US and 35% using CT. Using US as a gold standard, sensitivity of CT was 55%, specificity 85%, positive predictive value 78.6% and negative predictive value 34.6%. Percent agreement with CT and US was 70%. Cohen's kappa statistic adjusting for chance agreement was 40%. Based on these results, it is found that US yielded a higher percentage of positive cases of RPN.
对40名服用过量镇痛药（>1kg）的患者进行了计算机断层扫描（CT）和超声检查（US），以比较它们在镇痛药性肾病（AN）诊断中的价值。计算机断层扫描和超声检查的特征为肾乳头钙化。40名患者中，超声检查发现20例存在肾乳头坏死（RPN），CT检查发现14例存在肾乳头坏死。11名患者的超声检查和CT检查结果均为阳性。9名患者超声检查阳性而CT检查阴性。3名患者CT检查阳性而超声检查阴性。超声检查诊断RPN的患病率为50%，CT检查为35%。以超声检查为金标准，CT的敏感性为55%，特异性为85%，阳性预测值为78.6%，阴性预测值为34.6%。CT与超声检查的一致率为70%。校正机遇一致性后的科恩kappa统计量为40%。基于这些结果，发现超声检查诊断出的RPN阳性病例百分比更高。
