Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2021, Vol. 17 ›› Issue (01): 114 -119. doi: 10.3877/cma.j.issn.1673-5250.2021.01.017

Special Issue:

Review

Application of CT urography detection in diagnosis of congenital anomalies of kidney and urinary tract in children

Ning Ge1,1, Wenzhong Yang1,1,(), Shasha Zhang2,2, Ziwei Li1,1, Fangzhu Hua1,1   

  • Received:2020-05-20 Revised:2021-01-05 Published:2021-02-01
  • Corresponding author: Wenzhong Yang
  • Supported by:
    Scientific Research Project of Health Commission of Hubei Province(WJ2018H0136)

Congenital anomalies of kidney and urinary tract (CAKUT) in children are caused by embryonic developmental defects of kidneys and urinary tract. CAKUT, as a group of diseases with diverse chinical phenotypes, congenital anatomical abnormalities of urinary system are its main clinical features. CT urography (CTU) refers to the use of multi-slice spiral CT to perform angiography of whole urinary tract, and to post-process and reconstruct the obtained images to diagnose various urinary system diseases.During the excretion phase of CTU, urinary tract is filled with iodine contrast agent and shows high density development. It provides a good contrast with the surrounding low-density soft tissue, providing a basis for application of CTU in CAKUT children. This article mainly elaborates on latest research progress of different types and pathogenesis of CAKUT in children, comparison of different imaging diagnostic methods of CAKUT, the main points of CTU detection in CAKUT children, and how to reduce CTU radiation dose, etc., in order to provide a reference for minimizing radiation damage of CTU detection in CAKUT children.

[1]
戴石,张晓军,张新荣. IVP、CTU及MRU在儿童重复肾畸形中的诊断价值[J]. 中国医学计算机成像杂志,2015, 21(6): 571-574.
[2]
王旭,郭毅,陈寿康,等. 先天性肾脏畸形202例回顾分析[J]. 实用儿科临床杂志,2008, 23(5): 364-365. DOI: 10.3969/j.issn.1003-515X.2008.05.018.
[3]
Sanna-Cherchi S, Caridi G, Weng PL, et al. Genetic approaches to human renal agenesis/hypoplasia and dysplasia[J]. Pediatr Nephrol, 2007, 22(10): 1675-1684. DOI: 10.1007/s00467-007-0479-1.
[4]
Scott JE, Renwick M. Antenatal diagnosis of congenital abnormalities in urinary tract. Results from the Northern Region Fetal Abnormality Survey[J]. Br J Urol, 1988, 62(4): 295-300. DOI: 10.1111/j.1464-410x.1988.tb04351.x.
[5]
傅煜,李岭. 泌尿生殖系统的发育过程及其先天畸形的相关基因[J]. 中国优生与遗传杂志,2008, 16(5): 1-3, 99. DOI: 10.3969/j.issn.1006-9534.2008.05.001.
[6]
Barakat AJ. Presentation of the child with renal disease and guidelines for referral to the pediatric nephrologist[J]. Int J Pediatr, 2012, 2012: 978673. DOI: 10.1155/2012/978673.
[7]
Ruggenenti P, Perna A, Remuzzi G, et al. ACE inhibitors to prevent end-stage renal disease: when to start and why possibly never to stop: a post hoc analysis of the REIN trial results. Ramipril efficacy in nephropathy[J]. J Am Soc Nephrol, 2001, 12(12): 2832-2837. DOI: 10.1007/s10891-005-0119-1.
[8]
翁婷,郑怡,朴雪瑞,等. CTU在儿童先天性泌尿系畸形中的诊断价值[J]. 中国优生与遗传杂志,2018, 26(9): 76-77. DOI:10.13404/j.cnki.cjbhh.2018.09.034.
[9]
Baker LA, Gomez RA. Embryonic development of the ureter and bladder: acquisition of smooth muscle[J]. J Urol,1998,160(2):545-550. DOI:10.1016/S0022-5347(01)62956-2.
[10]
钟强,钱雯,张兢之,等.产前B超、MRI及高通量测序在先天性肾缺如中的应用[J]. 分子影像学杂志,2020, 43(4):643-646. DOI:10.12122/j.issn.1674-4500.2020.04.19.
[11]
唐光健,秦乃姗. 现代全身CT诊断学[M]. 3版. 北京:中国医药科技出版社,2013.
[12]
李占华,王振锋. 肾脏、输尿管重复畸形的影像学诊断进展[J]. 医学综述,2018, 24(21):4281-4285. DOI:10.3969/j.issn.1006-2084.2018.21.024.
[13]
高玉林. 泌尿系疾病64排螺旋CT尿路成像分析[J].世界最新医学信息文摘(连续型电子期刊), 2015,15(72):120. DOI:10.3969/j.issn.1671-3141.2015.72.106.
[14]
王建良,朱玉春,高迁,等.64层螺旋CT尿路成像技术在泌尿系统疾病中的临床应用[J]. 中国CT和MRI杂志,2012, 10(2):93-95. DOI:10.3969/j.issn.1672-5131.2012.02.031.
[15]
杨斌,张明聪,程伟.重复肾盂输尿管畸形诊治分析[J]. 中国医师进修杂志,2018, 41(12):1066-1069. DOI:10.3760/cma.j.issn.1673-4904.2018.12.003.
[16]
Tsao YT, Lin SH, Lin YF, et al. Pelvic ectopic kidney with acute pyelonephritis:wolf in sheep′s clothing[J]. Am J Emerg Med, 2008, 26(4): 517.e3-517.e4. DOI:10.1016/j.ajem.2007.08.023.
[17]
李成龙,张欣贤,郝向东,等. CTU皮质-分泌期图像对儿童异位肾的诊断价值[J].医学影像学杂志,2016,26(10):1873-1875.
[18]
王芳,丁洁.儿童肾脏囊性疾病[J]. 中华实用儿科临床杂志,2019, 34(5):321-323.DOI:10.3760/cma.j.issn.2095-428X.2019.05.001.
[19]
李劲松,李佳宁,傅宏亮,等.利尿肾动态显像在小儿先天性泌尿系统畸形中的应用[J]. 中华核医学杂志,2006,26(5): 285-287. DOI:10.3760/cma.j.issn.2095-2848.2006.05.008.
[20]
李宁宁,季丽娜,晁爽,等. 新生儿先天性肾脏和泌尿道畸形的超声筛查及随访[J]. 北京大学学报(医学版), 2019, 51(6):1062-1066. DOI:10.19723/j.issn.1671-167X.2019.06.015.
[21]
顾钱峰,夏文评. 肾盂输尿管连接部梗阻术前多层螺旋CT尿路造影的应用价值[J]. 中国全科医学,2010, 13(78):2282-2284. DOI:10.3969/j.issn.1007-9572.2010.20.037.
[22]
马睿,吴荣德,崔秀芳,等. 螺旋CT尿路成像在小儿上尿路疾病诊断中的价值[J]. 中华放射学杂志,2002, 36(12):1131-1137.DOI:10.3760/j.issn:1005-1201.2002.12.019.
[23]
Karava E, Gürel S, Kɩyan A,et al. Effect of prone and supine positioning on computed tomography urography examination[J].Urol Int, 2018,101(2):167-174. DOI:10.1159/000490735.
[24]
杨颖,韩飞.MSCT尿路成像在小儿先天性上尿路畸形的诊断价值[J]. 实用放射学杂志,2011, 27(2): 308-310. DOI:10.3969/j.issn.1002-1671.2011.02.043.
[25]
贾广生,张在人,李艳英,等. 64排螺旋CT泌尿系三维重建技术在输尿管病变中的临床应用[J]. 哈尔滨医科大学学报,2011,45(1):70-76.DOI: 10.3969/j.issn.1000-1905.2011.01.021.
[26]
Hansen J, Jurik AG. Survival and radiation risk in patients obtaining more than six CT examinations during one year[J].Acta Oncol, 2009, 48(2):302-307. DOI:10.1080/02841860802552477.
[27]
Dahlman P, Jangland L, Segelsj M, et al. Optimization of computed tomography urography protocol,1997 to 2008: effects on radiation dose[J].Acta Radiol, 2009, 50(4):446-454. DOI:10.1080/02841850902821757.
[28]
Shinagare AB, Sahni VA, Sadow CA, et al. Feasibility of low-tube-voltage excretory phase images during CT urography: assessment using a dual-energy CT scanner[J]. AJR Am J Roentgenol,2011,197(5): 1146-1151. DOI:10.2214/AJR.11.6799.
[29]
Sudakoff GS, Dunn DP, Hellman RS, et al. Opacification of the genitourinary collecting system during MDCT urography with enhanced CT digital radiography: nonsaline versus saline bolus[J].AJR Am J Roentgenol,2006,186(1):122-129. DOI:10.2214/AJR.04.1835.
[30]
马睿,赵子凤,刘伟,等. 儿童低剂量CT尿路成像的临床应用研究[J].中华小儿外科杂志,2014, 35(3): 174-178. DOI:10.3760/cma.j.issn.0253-3006.2014.03.004.
[31]
Dahlman P, van der Molen AJ, Magnusson M, et al. How much dose can be saved in three-phase CT urography? A combination of normal-dose corticomedullary phase with low-dose unenhanced and excretory phases[J]. AJR Am J Roentgenol,2012,199(4):852-860. DOI:10.2214/AJR.11.7209.
[32]
Kim JK, Park SY, Kim HJ, et al. Living donor kidneys: usefulness of multidetector row CT for comprehensive evaluation[J]. Radiology,2003,229(3):869-876.DOI:10.1148/radiol.2293021098.
[33]
张信起,刘怀军,王宁,等. 基于患者体质量指数双低剂量CT尿路成像的临床应用研究[J]. 实用放射学杂志,2018,34(7):1098-1102. DOI:10.3969/j.issn.1002-1671.2018.07.030.
[34]
Waaijer A, Prokop M, Velthuis BK,et al.Circle of willis at CT angiography: dose reduction and image quality--reducing tube voltage and increasing tube current settings[J].Radiology, 2007, 242(3): 832-839. DOI:10.1148/radiol.2423051191.
[35]
敖炜群,孙静. 低剂量CT尿路造影的研究进展[J].医学综述,2015, 21(18):3375-3377. DOI:10.3969/j.issn.1006-2084.2015.18.041.
[36]
吕蓉,陈晨,胡维娟,等. CT值与管电流、管电压的关系以及图像噪声与辐射剂量的相关性研究[J]. 实用放射学杂志,2020,36(1):123-127. DOI:10.3969/j.issn.1002-1671.2020.01.031.
[37]
敖炜群,孙静,刘军,等. 低剂量胸部CT自动管电流调节技术在超重体型患者检查中的可行性研究[J]. 现代生物医学进展,2014,14(2):292-295. DOI:10.13241/j.cnki.pmb.2014.02.024.
[38]
蒋骏,黄美萍,梁长虹,等. iDose重建技术在先天性心脏病低剂量CT成像中的应用[J].中华放射医学与防护杂志,2014,34(4):306-309. DOI:10.3760/cma.j.issn.0254-5098.2014.04.018.
[39]
赵子凤,柳澄,赵宁,等. Flash双源CT在小儿低剂量CT尿路成像中的应用[J]. 医学影像学杂志,2014,24(3):451-455.
[40]
牛亚婷,苏垠平,牛延涛,等.儿童CT扫描致癌风险评估研究进展[J].中华放射医学与防护杂志,2020, 40(2):156-160. DOI: 10.3760/cma.j.issn.0254-5098.2020.02.015.
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