南方医科大学学报

南方医科大学学报 ›› 2013, Vol. 33 ›› Issue (10): 1467-.

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Sonovue排泄性超声尿路造影与X线膀胱尿路造影的比较研究

邓劲松，周路遥，曾斯慧，张春丽，曾广绥，王洁，陈庆康   

  • 出版日期:2013-10-20 发布日期:2013-10-20

Voiding urosonography with SonoVue and fluoroscopic voiding cystourethrography in evaluation of vesicoureteral reflux: a comparative study

  • Online:2013-10-20 Published:2013-10-20

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摘要： 目的探讨Sonovue排泄性尿路超声造影（VUS）评估膀胱输尿管返流（VUR）的价值。方法纳入36例［共72个肾盂-输尿
管单位（Pyelo-Ureter Units, PUUs）］临床疑为膀胱输尿管返流且同时进行了VUS和排泄性X线膀胱尿路造影（VCUG）的儿童
病人。比较VUS和VCUG发现VUR的敏感性和一致性。根据返流分级标准比较两者判断返流分级的一致性。结果72 个
PPUs，VUS发现26个PUUs（36.1%，26/72），而VCUG发现21个PUUs（29.2%）存在返流，两者对返流检出率的差异无统计学意
义（P=0.347）。65个PUUs（90.3%，65/72）的结果在两种方法完全一样（McNemar检验，Kappa值=0.843），表明两者的一致性较
好。另外，VUS经会阴部观察还显示了2个病例的后尿道瓣膜。结论Sonovue介导的VUS在检测和分级膀胱输尿管反流上不
差于甚至优于VCUG，且更安全，应该作为膀胱输尿管返流的首选筛查和随访工具。另外，VUS经会阴部观察对评估后尿道病
变也有一定帮助。

Abstract: Objective To assess the value of voiding urosonography (VUS) with SonoVue in evaluation of vesicoureteral reflux.
Methods Thirty-six pediatric patients (72 pyeloureter units [PUUs]) suspected of vesicoureteral reflux underwent both VUS
and fluoroscopic voiding cystourethrography (VCUG). The sensitivity of VUS and VCUG and their consistency in detecting
vesicoureteral reflux as well as in grading vesicoureteral reflux were compared. Results Vesicoureteral reflux was detected in
26 of the 72 PUUs (36.1%) by VUS while in 21 PUUs (29.2%) by VCUG (P=0.347). The two modalities yielded the same results
for 65 PUUs (κ=0.843), showing a very good consistency between them. VUS also detected post-urethral valve in 2 patients via
transperineal scans. Conclusion VUS with Sonovue has at least comparable, if not better, sensitivity in detecting vesicoureteral
reflux with VCUG, and therefore should serve as the primary screening and follow-up modality for vesicoureteral reflux. In
addition, transperineal VUS can be helpful in evaluation of post-urethral lesions.