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中华腔镜泌尿外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (02) : 102 -106. doi: 10.3877/cma.j.issn.1674-3253.2018.02.009

所属专题: 文献

临床研究

低剂量CT尿路成像辅助定位行经皮肾镜术的可行性研究
付晓华1, 张英晨2, 丁吉阳2, 孙浩2, 赵帅2, 栾志敏3, 蒋立城2,()   
  1. 1. 261000 山东,潍坊医学院
    2. 255300 山东淄博,解放军第148中心医院泌尿外科
    3. 261000 山东,潍坊医学院附属医院泌尿外科
  • 收稿日期:2017-05-11 出版日期:2018-04-01
  • 通信作者: 蒋立城

The feasibility of low-dose CT urography-assisted positioning of percutaneous nephrolithotomy

Xiaohua Fu1, Yingchen Zhang2, Jiyang Ding2, Hao Sun2, Shuai Zhao2, Zhimin Luan3, Licheng Jiang2,()   

  1. 1. WeifangMedical University, Shandong 261000, China
    2. Department of Urology, 148th Center Hospital of People's Liberation Army, Zibo, Shandong 255300, China
    3. Department of Urology, the Affiliated Hospital of Weifang Medical University, Shangdong 261000, China
  • Received:2017-05-11 Published:2018-04-01
  • Corresponding author: Licheng Jiang
  • About author:
    Corresponding author: Jiang Licheng, Email:
引用本文:

付晓华, 张英晨, 丁吉阳, 孙浩, 赵帅, 栾志敏, 蒋立城. 低剂量CT尿路成像辅助定位行经皮肾镜术的可行性研究[J]. 中华腔镜泌尿外科杂志(电子版), 2018, 12(02): 102-106.

Xiaohua Fu, Yingchen Zhang, Jiyang Ding, Hao Sun, Shuai Zhao, Zhimin Luan, Licheng Jiang. The feasibility of low-dose CT urography-assisted positioning of percutaneous nephrolithotomy[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(02): 102-106.

目的

探讨低剂量CT尿路成像(CTU)辅助定位行经皮肾镜碎石取石术(PCNL)的可行性。

方法

选取10例需行PCNL治疗的上尿路结石患者,采用自身对照,所有患者均于排泄期先行常规剂量(250 mA)CT扫描,然后即刻行低剂量(50 mA)扫描,两组图像进行独立评估上尿路结石征象、肾积水程度、肾周组织器官情况和定位参数(穿刺角度、穿刺深度),对两组数据进行统计学分析。

结果

两组图像均能满足影像学诊断。以常规剂量CTU图像为参照标准,低剂量CTU对结石征象、肾周组织情况的显示率为100%。低剂量和常规剂量CTU在定位参数、肾盏形态构象方面比较差异无统计学意义(P>0.05),而在有效辐射量方面差异有统计学意义(P<0.01)。

结论

对适合行PCNL治疗的上尿路结石患者,在应用CTU扫描定位时,可以以低剂量CTU扫描取代常规剂量CTU扫描作为常规首选的定位方法,能有效降低患者围手术期的放射辐射量。

Objective

To explore the feasibility of low-dose CT urography-assisted positioning of PCNL.

Methods

Ten patients with upper urinary calculi requiring PCNL treatment were selected. All patients underwent conventional dose (250 mA) CT in excretion and then low dose (50 mA) scan was taken immediately. Signs of upper urinary tract calculi, degree of hydronephrosis, situation of perirenal tissues and organs and location parameters (angle of puncture, depth of puncture) of the two groups of images were assessed independently; statistical analysis was conducted on the two groups of data.

Results

The two groups of images could meet the imaging diagnosis. Regarding conventional dose CTU image as the reference standard, low dose CTU could show the signs of calculi and situation of perirenal tissues completely. Low dose and conventional dose CTU presented no statistically significant difference (P>0.05) in location parameters and conformation of renal calyx, but in effective radiation (P<0.01).

Conclusion

For patients with upper urinary calculi who are suitable for PCNL treatment, low dose CTU scan can substitute for conventional dose CTU scan and become the preferred location method when CTU scan is applied, and it can effectively reduce the radiation level in patients during perioperative period.

表1 10例患者低剂量和常规剂量CTU图像质量评分的情况
表2 10例患者低剂量和常规剂量CTU扫描所示结石位置、肾积水程度、胶粒显像、肾周组织脏器位置关系(例)
表3 10例患者低剂量和常规剂量CTU扫描的轴面结石大小、穿刺肾盏情况、定位参数以及有效辐射量(±s
图4 常规剂量(4a)和低剂量(4b)CTU显示肾盏角度、盏径长度和盏颈宽度情况
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