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頁籤選單縮合
題名 | Diagnostic Value of Unenhanced Computerized Tomography Urography in the Evaluation of Acute Renal Colic=未施打顯影劑之電腦斷層尿路攝影在急性腎絞痛之診斷價值 |
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作者 | 王家槐; 林文瓊; 韋朝榮; 張政彥; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷期 | 19:10 2003.10[民92.10] |
頁次 | 頁503-509 |
分類號 | 415.842 |
關鍵詞 | 電腦斷層尿路攝影; 腎絞痛; 尿路結石; CT urography; Renal colic; Urolithiasis; |
語文 | 英文(English) |
中文摘要 | 目的:本文為一前瞻性的研究,旨在評估未施打影顯劑之電腦斷層尿路攝影應用在急性腎絞痛的診斷價值。材料及方法:59 位臨床表現為急性腎絞痛之患者,未注射顯影劑之電腦斷層攝影以評估其集尿系統問題。所有病人之電腦電層尿路攝影皆是由電腦斷層影像以三度立體重組而成。經由比較患者之電腦斷層尿路攝影結果、輸尿管鏡檢查、手術及病理發現作一比較。結果:在所有患者中,發現 57 位有尿路系統問題,45 位是腎結石病患,3 位是尿路惡性腫瘤,1 位先天性尿路異常,8 位輸尿管狹窄(因慢性發炎或纖維化所造成),2 位無異常發現。其中只有一位尿結石病患由電腦斷層尿路攝影誤診為腎臟腫瘤。而另外有 6 位病患藉由電腦斷層尿路攝影發現其他非集尿系統之異常(2 位為肺部異常表現,4 位為膽結石)。因此,經由電腦斷層尿路攝影正確診斷出尿路結石之敏感度為 97.8%,特異度 100%。結論:電腦斷層尿路攝影為一新近發展用以評估集尿系統疾病之檢查,其高度的正確診斷率是可將其列為評估尿路問題的另一選擇。 |
英文摘要 | This study prospectively evaluated the diagnostic value of unenhanced computerized tomography (CT) urography in patients with acute renal colic. Fifty-nine patients with clinical manifestations of acute renal colic underwent unenhanced helical CT to evaluate urinary tract abnormalities. Reformatted three-dimensional CT urography was performed in all patients. The findings were correlated with ureteroscopy, surgical findings, histopathologic findings, and clinical course. CT urography detected urinary abnormalities in 57 of 59 patients with the clinical manifestation of acute renal colic, including 45 cases of urolithiasis, three urinary malignancies, one congenital abnormality, and eight ureteral strictures (due to chronic inflammation or fibrosis). CT urography showed negative findings in the urinary system in two patients, and after clinical follow-up, urinary abnormality was excluded in these patients. Incidental findings of extrarenal disease were noted in six patients (pulmonary abnormalities, n = 2; gallstones, n = 4). Only one patient with urolithiasis was misdiagnosed as having a renal tumor by CT urography. The sensitivity and specificity of CT urography in diagnosing urolithiasis was 97.8% (44/45) and 100% (14/14), respectively. Three-dimensional CT urography is a newly developed modality to evaluate anomalies of the urinary tract. The highly accurate diagnostic value of CT urography makes it a suitable alternative or substitutive modality in patients with acute flank pain. |
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