网络首发时间：2017-11-0917:40临床泌尿外科杂志2017,11（32）,836-839DOI:10.13201/j.issn.1001-1420.2017.11.004IVP联合IVP后泌尿系三维重建CT在诊断小儿重复肾畸形中的价值孙洪赞张立欧张思雨中国医科大学附属盛京医院放射科导出/参考文献关注分享收藏打印摘要：目的:探讨静脉肾盂造影（IVP）联合IVP后泌尿系三维重建CT在诊断小儿先天性重复肾畸形中的临床应用价值。方法:40例经术后病理证实的小儿先天性泌尿系重复肾畸形患者，在术前1周内分别行常规泌尿系超声检查、IVP及IVP后CT扫描检查，CT图像后处理釆用曲面重建（CPR）、多平面容积重现（MPR）、最大密度投影（MTP）、容积再现技术（VRT）等方法，比较三种成像方法的诊断准确性及对重复肾畸形分型的价值。结果:超声检查确诊31例，诊断准确率77.5%;IVP检查确诊26例，诊断准确率65.0%;IVP联合IVP后CT检查确诊38例，诊断准确率95.0%。而在对已确诊的40例重复肾患者分型中，超声检查分型正确率为70%;IVP分型正确率为55.0%;IVP联合IVP后泌尿系CT检查分型准确率达92.5%;TVP联合TVP后三维重建CT诊断准确率及分型准确率高于超声检查及单纯IVP检查（P〈0.05）。结论：IVP联合IVP后三维重建CT技术对小儿泌尿系重复肾畸形有较好的诊断准确性及分型准确性，可指导临床治疗方式。关键词：静脉肾盂造影;计算机断层扫描技术;三维重建;重复肾;作者简介：孙洪赞，E-mail:sunhz@sjdhospital.org收稿日期：2017-10-06基金：W家自然科学基金青年基金（编号81401438）ValueofIVPcombinedwithCT-3DreconstructionfollowingIVPinthediagnosisofduplexkidneyinchildrenSUNHongzanZHANGLi’ouZHANGSiyuDepartmentofRadiology，ShengjingHospitalofChinaMedicalUniversity;Abstract：Objective:Toinvestigatethevalueofintravenouspyelography(IVP)combinedwithCT-3DreconstructionfollowingIVPinthediagnosisofduplexkidneyinchildren.Method:Childrenwithcongenitalurinarysystemanomalyin40caseswithpathologicallyconfirmedduplicationofkidneywereperformedroutineurinarysystemultrasonography,IVPandCTscanfollowingIVPwithinoneweekbeforesurgery,CTimagespostprocessingbycurvedplanarreformation(CPR)，multiplanarreformation(MPR)，themaximumintensityprojection(MIP)，volumerenderingtechnique(VRT)methods.Wecomparedthediagnosticaccuracyandthevalueoftypingofduplexkidneyamonethreeimagingmethods.Result:Thirty-onecaseswerediagnosedbyultrasound,thediagnosticaccuracyratewas77.5%;26caseswerediagnosedbyIVPexamination,thediagnosticaccuracyratewas65.0%;38caseswerediagnosedbyCTfollowingIVPcombinedwithIVP,thediagnosticaccuracyratewas95.0%.Whilein40caseswithduplexkidneyfordiagnosedtype,ultrasoundclassificationaccuracyratewas70%;IVPclassificationaccuracyratewas55.0%;IVPcombinedwithCTfollowingIVPclassificationaccuracyratewas92.5%;IVPcombinedwiththree-dimensionalreconstructionofCTfollowingIVPdiagnosticaccuracyandclassificationaccuracywashigherthanthatofultrasoundandTVPexaminationalone(P<0.05).Conclusion:IVPcombinedwiththree-dimensionalreconstructionofCTfollowingIVPhasgooddiagnosticaccuracyandclassificationaccuracyinchildrenwithurinarysystemduplexkidneydisease,whichcanguidetheclinicaltreatment.Keyword：intravenouspyelography;computedtomography;three-dimensionalreconstruction;duplexkidney;Received：2017-10-06重复肾是儿童泌尿系排名第2位的先天性畸形，其左、右侧发病概率大致相同，双侧发病者占1/10左右U1。重复肾常常合并异位输鉍管开口、输鉍管囊肿等其他畸形，例如尿路感染、腹部包块、排尿困难、尿淋漓、尿毒症等。但大多数单纯重复肾患者无明显临床症状和体征，常因行影像学检查而被发现。既往诊断主要依靠超声、静脉肾盂造影（IVP）,但这2种成像方法均存在一定的局限性。近年来，随着TVP后补扫CT成像方法兴起，由于其一次性给药便可获得TVP以及CT...