微创医学

目的分析CT造影检查中不同造影剂浓度及剂量方案诊断泌尿系统疾病的临床效果。方法选取2020年1月至2021年1月期间在南宁市红十字会医院行CT尿路造影检查的90例患者作为研究对象，其中接受常规浓度、常规剂量CT造影检查的45例患者设为对照组，同期接受优化浓度与剂量方案CT造影检查，且一般资料与对照组均衡可比的45例患者设为观察组。对比两组患者的造影图像效果以及双肾、输尿管和膀胱的对比度噪声比（CNR），血肌酐水平等指标的差异。结果两组患者的造影图像效果比较，差异无统计学意义（P>0.05）。两组患者双肾、输尿管层面的CNR比较，差异均无统计学意义（均P>0.05）；观察组患者膀胱层面的CNR高于对照组，差异有统计学意义（P<0.05）。观察组造影剂用量为（44.00±3.81）mL，对照组造影剂用量为（66.03±3.51）mL，组间差异有统计学意义（P<0.05）。造影前，两组患者的血肌酐水平比较，差异无统计学意义（P>0.05）；造影后，两组患者的血肌酐水平均有所提高，但观察组血肌酐水平低于对照组，差异有统计学意义（P<0.05）。观察组造影后发生急性肾功能损伤2例（4.44%），对照组造影后发生急性肾功能损伤10例（22.22%），组间差异有统计学意义（P<0.05）。结论小剂量、低浓度造影剂能够获得与传统浓度剂量方案相当的图像质量，且具有安全性更高的优势，可有效降低急性肾功能损伤的发生率，值得临床应用推广。

Objective To make an effectiveness evaluation of different contrast medium concentrations and dosage regimens on the diagnosis of urinary system diseases in CT angiography. Methods A total of 90 patients who underwent CT urography at at Nanning Red Cross Hospital from January 2020 to January 2021 were selected as the research subjects. Among them, 45 patients who received CT angiography with the conventional contrast medium concentration and dosage were set as the control group. At the same time, 45 patients who received CT angiography with the optimized contrast medium concentration and dosage regimen and whose general data were comparable to those of the control group were set as the observation group. The contrast-to-noise ratio (CNR) of the bilateral kidneys, ureters, and bladders, as well as the serum creatinine levels and other relevant indicators, were compared between the two groups. Results There was no statistically significant difference in the contrast image effects between the two groups (P>0.05). No statistically significant difference was observed in the CNR of the bilateral kidneys and ureters between the two groups (all P>0.05). However, the CNR at the bladder level in the observation group was significantly higher than that in the control group, with a statistically significant difference (P<0.05). The volume of contrast agent administered to the observation group was (44.00±3.81) mL, while that for the control group was (66.03±3.51) mL, with a statistically significant difference between the two groups (P<0.05). Before angiography, the serum creatinine levels of the two groups showed no statistically significant difference (P>0.05). After angiography, although the serum creatinine levels increased in both groups, the level in the observation group was significantly lower than that in the control group, with a statistically significant difference (P<0.05). After angiography, acute renal injury occurred in 2 cases (4.44%) of the observation group and 10 cases (22.22%) of the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Contrast agents administered at low doses and concentrations can generate images with quality equivalent to that of the conventional concentration-dosage regimen, and has the advantages of higher safety, which can effectively reduce the incidence of acute renal injury, and is worthy of clinical application and promotion.