摘要
目的探讨彩色多普勒血流成像(CDFI)与核素肾动态显像对单侧梗阻性重度肾积水静脉尿路造影(IVU)不显影患者的肾功能评价价值。方法收集51例因单侧梗阻性肾积水经IVU检查不显影患者,分别采用CDFI测定肾内血流阻力指数(RI),采用核素肾动态显像测定患肾肾小球滤过率(GFR),以此判断患肾肾功能,并与肾穿刺造瘘后24h引流量对比分析患肾肾功能。结果造瘘前,CDFI诊断20例患肾有功能,平均RI为0.71±0.05,核素肾动态显像诊断14例有功能,平均GFR为(48.5±6.4)ml/min;造瘘后,CDFI诊断21例患肾有功能,平均RI为0.68±0.02,核素肾动态显像诊断22例有功能,平均GFR(56.1±5.3)ml/min。造瘘后24h引流量显示,22例有功能,29例无功能。卡方检验显示,造瘘前判断肾脏是否有功能的正确率,CDFI(96.07%)高于核素肾动态显像(84.31%,P<0.05);肾造瘘后核素肾动态显像(100.00%)则略高于CDFI(98.04%),但差异无统计学意义(P>0.05)。结论对于单侧梗阻性肾重度肾积水IVU不显影患者,术前采取CDFI评估重度积水肾脏的功能具有无创、快速、经济和准确率较高的特点,易于在基层推广应用。
Objective To compare the significance of color Doppler ultrasonography （CDFI） and nuclide nephro-dynamic imaging （SPECT） on functional evaluation of the kidney with no image on intravenous urography （IVU）. Methods A total of 51 patients with severely chronic obstructive hydronephrosis who had no image on IVU were enrolled in this study. The Doppler resistive index （RI） of renal blood flow and the glomerular filtration rate （GFR） of sick kidneys were detected by CDFI and nuehde renal dynamic imaging respectively to evaluate the function. All the results were compared with the findings of 24 h drainage volume after percutaneous puncture. Results Among the 51 kidneys, 20 were diagnosed by CDFI and mean RI was 0.71±0.05, but 14 were diagnosed by nuclide renal dynamic imaging and mean GFR was 48.5 ±6.4 ml/min. While after percutaneous renal puncture, 21 were diagnosed by CDFI and mean RI was 0.68± 0.02, 22 were diagnosed by nuclide renal dynamic imaging and mean GFR was 56. 1 ± 5.3 ml/min. The 24 h drainage volume after renal puncture showed that 22 were functional and the rest 29 were non-functional. From the results of chi square （ X2 ） test, the correct rate of diagnosis about renal function of CDFI （96.07 % ） was higher than that of nuclide renal dynamic imaging （ 84.31%, P 〈 0.05） before the renal obstruction was released. However, the correct rate of nuclide renal dynamic imaging （ 100.00% ） was higher than that of CDFI （98.04%） after velease, but the difference between was no statistically significant （ P 〉 0.05）. Conclusions To evaluate the function of kidneys suffering from hydronephrosis with no image on IVU, the correct rate of CDFI was significantly higher than that of nuclide renal dynamic imaging before the hydronephrosis was released by percutaneous renal puncture but without significance for evaluating the renal function.
出处
《中华医学超声杂志（电子版）》
2009年第4期56-59,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
高等学校博士学科点专项科研基金资助(NO20060486054)
