CT urography: a comparison of strategies for upper urinary tract opacification
CT urography: a comparison of strategies for upper urinary tract opacification
复制标题
CT尿路造影：上尿路混浊策略的比较
DOI：
10.1007/s00330-006-0462-4
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发表时间：
2007
影响因子：
5.9
通讯作者：
K. Taori
中科院分区：
文献类型：
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作者：
R. Sanyal;A. Deshmukh;Virender Singh Sheorain;K. Taori
对于确保CT尿路造影术(CTU)中最大限度地显示输尿管的最佳策略，目前尚未达成共识。在这项研究中，我们比较了不同的CTU方案，试图建立最佳的输尿管显示方法。试验分为仰卧位生理盐水输注、俯卧位生理盐水输注、呋塞米10 mg静注、丁斯可潘20 mg静注和俯卧位生理盐水输注4组，每组15例。将盆腔肾系和输尿管分为6段，对每段进行不混浊评分(0，未混浊段；1，不足50%混浊段；2，50~99%混浊段；或3，完全混浊段)，并进行比较。速尿治疗导致93%的输尿管完全混浊(28/30)。在输尿管远端(坐骨神经切迹下)，速尿的平均评分为2.9分，而生理盐水、仰卧位和俯卧位的平均评分分别为1.87和1.83，差异有非常显著意义(P = 0.0002和P = 0.0001)。也明显高于舒舒普组(2.3分，P = 0.002)。同样，在输尿管下部(从髂骨至坐骨神经切迹)和输尿管上部(在髂骨上方)，速尿在这两个位置的得分均显著高于生理盐水。仰卧位和俯卧位的生理盐水输注在所有节段都有非常相似的评分，低于Buscopan组，但这种差异在统计学上没有显著意义。CT尿路造影术中，低剂量速尿是输尿管显影最有效、最方便的方法。
A consensus is yet to be reached regarding the best strategy for ensuring maximum ureteric delineation during CT urography (CTU). In this study we have compared various CTU protocols to try to establish the best method for ureteric delineation. Saline infusion in the supine position, saline infusion in the prone position, furosemide administration (10 mg, iv) and buscopan administration (20 mg iv) with saline infusion in the prone position were tried in four groups, each having 15 patients who were undergoing CTU. The pelvicalyceal system and ureter were divided into six segments, to each of which an opacification score was assigned (0, unopacified segment; 1, less than 50% opacified segment; 2, 50–99% of the segment opacified; or 3, completely opacified segment) and the results compared. Furosemide administration resulted in complete opacification of 93% of the ureters (28 of 30). In the distal (below the sciatic notch) ureter, the mean score with furosemide was 2.9, while that with saline, supine and prone positioning was 1.87 and 1.83, respectively, and this difference was highly significant (P = 0.0002 and P = 0.0001). It was also significantly higher than the buscopan group (score 2.3, P = 0.002). Also in the lower (the iliac crest to the sciatic notch) and upper (above the iliac crest) ureter, furosemide had significantly higher scores than saline infusion in either position. Saline infusion in the supine and prone positions had very similar scores in all segments that were less than the buscopan group, but this difference was not statistically significant. During CT urography, furosemide administration in low doses is the most effective and convenient technique for ureteric opacification.