目的 对比多层螺旋CT尿路成像与超声造影诊断肾结核的效果.方法 回顾性分析2015年1月至2017年12月本院疑诊为肾结核的患者174例,其中肾结核105例,其他69例.均已进行多层螺旋CT尿路成像与超声造影,对比诊断效用及两种技术影像学表现.结果 多层螺旋CT尿路成像诊断肾结核灵敏度、阴性预测值、符合率高于超声造影,差异有统计学意义(P<0.05),两种技术的特异度、阳性预测值差异无统计学意义(P>0.05).多层螺旋CT尿路成像诊断肾结核的肾实质瘢痕化、肾区钙化率高于超声造影,差异有统计学意义(P<0.05);两种技术显示肾脏形态异常、肾盏异常、肾实质空洞、虫蚀样改变、肾自截、肾外表现、肾盂输尿管壁增厚、积水显示、肾功能减退率差异无统计学意义(P>0.05).结论 多层螺旋CT尿路成像诊断肾结核的效用优于超声造影,特别在肾实质瘢痕化、肾区钙化显示方面有一定的优势,但超声造影操作简单、安全、廉价.%Objective To compare the effect of multi-slice spiral CT urography and contrast-enhanced ultrasound in the diagnosis of renal tuberculosis. Methods From January 2015 to De-cember 2017, 174 cases of suspected renal tuberculosis were analyzed retrospectively, including 105 cases of renal tuberculosis and 69 other cases. Multi-slice spiral CT urography and contrast-enhanced ultrasound had been performed to compare diagnostic utility and two imaging techniques. Results The sensitivity, negative predictive value and coincidence rate of multi-slice spiral CT urography were higher than those of contrast ultrasound(P<0. 05). There was no significant difference in the spec-ificity and positive predictive value of the two techniques ( P>0. 05 ) . The rate of renal parenchyma cicatrization and calcification in renal area was higher than that of contrast-enhanced ultrasound in the diagnosis of renal tuberculosis with multi-slice spiral CT urographic imaging(P<0. 05). The two tech-niques showed that abnormal renal morphology, abnormality of kidney, renal parenchyma cavity, alter-ation of insect erosive sample, kidney self cut, appearance of kidney, thickening of renal pelvis and u-reter wall, and water accumulation, the rate of renal dysfunction were not statistically significant( P>0. 05 ) . Conclusions The utility of multi-slice spiral CT urography in the diagnosis of renal tuberculo-sis is superior to that of ultrasound, especially in renal parenchyma scar and renal calcification, but the operation is simple, safe and cheap.
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