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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 value of spiral CT dynamic contrast-enhanced scanning (SCTDCS) and pathological diagnosis of renal interstitial fibrosis (RIF). Methods 100 cases of primary renal plain scan, then 2.5mL / s from the forearm vein injection of Ultravist (1.5mL / kg), delayed scan 30 ~ 600s; collimation 3mm, pitch 1.5,1.5mm spacing reconstruction; source like input AW4. 0 workstation line multi-mode three-dimensional reconstruction process. Measurement of kidney, medullary thickness, CT value and kidney volume. Imaging diagnosis and pathological renal biopsy (KBP) control; SPSS10.0 statistical package, χ2 test and analysis of variance. Results 30 cases of normal, mild, moderate and severe RIF 45,22,3 cases. There was a significant difference between the normal group and the moderate RIF group (P <0.05); the slight nodules and other signs of moderate and severe RIF group were significantly increased; the differences between SCTDCS and SCTDCS The sensitivity and accuracy of pathological diagnosis of mild, moderate and severe RIF were 60% / 70%, 73% / 80%, 100% / 88% and specificity were 87%. Conclusion The combination of KBP and SCTDCS can provide a comprehensive and accurate imaging basis for RIF diagnosis.