摘要
目的评价螺旋CT动态增强扫描(SCTDCS)与病理对照诊断肾间质纤维化(RIF)的价值。方法100例先行肾脏平扫,后以2.5mL/s从前臂静脉注射Ultravist(1.5mL/kg),延迟30￣600s扫描;准直3mm,螺距1.5,1.5mm间距后重建;源像输入AW4.0工作站行多模式三维重建处理。测量肾皮、髓质厚度、CT值与肾脏体积。影像诊断与肾穿刺病理(KBP)结果对照;采用SPSS10.0统计学软件包,χ2检验及方差分析。结果30例正常,轻、中、重度RIF各45、22、3例。正常组与中度RIF组对照,肾皮/髓质厚度比、SCTDCSCT值及肾体积改变均差异具有显著性(P<0.05);中、重度RIF组微小结节影等征明显增加;SCTDCS与病理对照诊断轻、中、重度RIF的敏感性/准确性各为60%/70%、73%/80%、100%/88%;特异性均为87%。结论结合KBP,SCTDCS对RIF诊断能提供较全面准确的影像学依据。
[Objective] To evaluate the clinical value for renal interstitial fibrosis using spiral CT dynamic contrast scan （SCTDCS） and kidney biopsy Pathology（KPB）. [Methods] 100 cases were scanned using Hispeed NX/i scanner. A volume of 80-120 mL （1.5 mL/kg body weight） Ultravist （30 g Iodine/100 mL） was injected at rate 2.5 mL/s with a scan delay of 30-600 s. Single continuous volume scan was used with 3 mm collimation （HQ）, pitchl.5 and reconstruction interslice distance 1.5 mm.The source images were transferred to an independent workstation AW4.0 for multimodel 3D reconstruction （MM3DR）. The thickness of renal cortex and medulla,CT value and the volume of kidney of kidney were mearsured respectively. Diagnoses of images were compared with pathology of kidney biopsy. The data were statistically analyzed with the software of SPSS 10.0. [Results] 30 cases were nomal.The other cases of slight,moderate and severe RIF were 45, 22, 3 respectively. Normal group being compared with moderate RIF group, the ratio of thickness and SCTDCS＇CT value of kidney cortex and medulla showed the statistical significance （P 〈0.05）. Micronoule and vascular bundle sign and fibrotic scar increased more in moderate and severe RIF group than that in slight group. The sensitivity and accuracy of SCTDCS for examined RIF in slight, moderate and severe group were 60%/70%, 73%/80% and 100%/88%, respectively. Their Specificity all were 87%. [Conclusion] Integrated clinical KPB and emphasizing collecting multiperiod scan data with moderate MM3DR, SCTDCS can provide useful information in detection of RIF.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2005年第23期3655-3659,3662,共6页
China Journal of Modern Medicine
基金
2003年韶关市医药卫生科研资助重点项目(No:y0318)
关键词
肾间质纤维化/诊断
计算机断层
三维重建
肾活检
renal intertitial fibrosis/diagnosis
computed tomography
three-dimensional reconstruction
renalbiopsy
