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題名 | 疼痛位置於斜位相靜脈注射尿路攝影術對輸尿管結石位置之評估=Evaluation of the Cause of Ureteral Stone Location with Intravenous Urography(IVU)-better Location of the Stone with Oblique View |
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作者 | 程勇清; 蔡建昇; 黃致民; 謝麗莎; 林經隆; | 書刊名 | 中華放射線技術學雜誌 |
卷期 | 35:3 2011.09[民100.09] |
頁次 | 頁154-158 |
分類號 | 416.27 |
關鍵詞 | 靜脈注射尿路攝影術; 斜位相攝影; 鼠蹊痛; 輸尿管結石; Intravenous urography; IVU; Oblique view; Groin pain; Ureteral stone; |
語文 | 中文(Chinese) |
中文摘要 | 放射師藉由靜脈注射尿路攝影術檢查單的懷疑結石診斷,進而詳細詢問病患病史和結石疼痛位置及走向,配合不同的尿路結石位置有不同的疼痛方式,再使用靜脈注射尿路攝影術中的斜位相攝影,可以有效印證及提升中、下段輸尿管結石準確度及再現性,進而提升放射師之本質學能及自主性。本研究由2008年12月至2009年6月止,共收集268例,由泌尿科門診轉介至放射診斷科施行靜脈注射尿路攝影術檢查,並且排除無急性腹側痛或腎絞痛及血尿的結石臨床症狀患者,共40例,實際符合研究對象共228例。本次研究所使用X光機為德國西門子(SIEMENS)公司生產製造,型號Polydoros LX50,湳開公司之富士CR數位影像系統及中華系統整合股份有限公司之PACS系統。我們使用靜脈注射尿路攝影術中之斜位攝影,配合詢問病患病史及結石疼痛位置及申請醫師主述,針對由後腹輕微酸痛、由後腹痛至前腹、由後腹痛至鼠蹊處及由後腹痛至膀胱或睪丸之4類病患,共80例,適當使用斜位攝影,再予以評估中、下段輸尿管結石的準確性。結果呈現在由後腹痛至鼠蹊處的病患群中,有斜位相攝影,且確定為中、下段輸尿管結石,佔66.7%,在同一病患群中,有斜位相攝影,但無中、下段輸尿管結石,佔33.3% ; 在由後腹痛至膀胱或睪丸的病患群中,有斜位相攝影,且確定為中、下段輸尿管結石,佔80%,在同一病患群中,有斜位相攝影,但無中、下段輸尿管結石,佔20% ; 由此可知,使用斜位相攝影配合詢問病患結石輻射痛至鼠蹊、膀胱、睪丸或大腿內側,可以有效提升中、下段輸尿管結石準確度及再現性,也可使放射師更了解靜脈注射尿路攝影術中斜位相攝影之自主性的使用時機。結石的疼痛位置,會因病患的心理或生理因素影響,造成放射師的誤判,所以放射師在使用斜位相攝影的自主時機,必須充分了解詢問病患病史,結石疼痛位置及現場病患之輸尿管顯影狀況,才可使中下段輸尿管結石配合斜位相攝影而明顯及精準的呈現出。 |
英文摘要 | Being a greatly radiological technologist, IVU is a routine work and the result is most important for the clinical doctor, especially the urologist. For better result medical radiation technologist should be informed of the patient’s clinical history, the suspension location of the stone before the IVU examination. We determined the value that location of suspected ureteral colic matched with oblique view of IVU in the evaluation of IVU. From December 2008 to June 2009, we included 228 consecutive patients (160 men and 68 women) with suspected urinary stone disease or the pain may intensify and radiated to the groin‚testicles‚ or labia that underwent IVU. In this study, we use SIEMENS Model Polydoros LX50, Fuji Computer Radiograph (FCR) and PACS in our institution. We retrospectively analyzed in 80 patient the oblique view is truly important for localization of the stone during IVU. The symptom of these 80 patients, including mild flank pain, pain radiated to abdomen, pain radiated to inguinal region, pain radiated the bladder and testis. By using the oblique view during the IVU, and location of pain related, we can easily confirm the diagnosis. A total of 80 patients had adequate oblique view to assess outcome accurately. Of 18 patients 12 with an oblique view (66.7%) confirmed the middle or lower ureteral stones for radiation pain to inguinal group. Of 10 patients 8 with an oblique view (80%) confirmed the middle or lower ureteral stones for radiation pain to urinary bladder or testis group. There were 3 patients without the oblique view of IVU who had the middle or lower ureteral stones. Oblique view of IVU matched with location of calculi pain was accurate and reliable in detecting the middle or lower ureteral stones. |
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