泌尿系造影联合彩色多普勒对小儿先天性肾积水的诊断价值评估.

Objective: To investigate the diagnostic value of urography combined with color Doppler in children with congenital hydronephrosis. Methods: A total of 88 children with congenital hydronephrosis treated in our hospital from November 2018 to November 2021 were selected as the study subjects. All children perfectintravenous pyelography and color Doppler ultrasonography, the pathological diagnostic result was used as the gold standard,and the diagnostic value of the two examination methods in children with congenital hydronephrosis was compared. Results: The results of color Doppler ultrasound showed that there were 10, 39 and 39 children with mild, moderate and severe hydronephrosis respectively. Compared with children with different degrees of illness, the peak systolic velocity (PSV） and minimum diastolic velocity (EDV） in the severe group were lower than those in the moderate and mild group, and the blood flow resistance index (RI） in the severe group was higher than those in the moderate and mild group (P＜0.05), but there was no significant difference in PSV, EDV and RI between mild group and moderate group (P＞0.05). Compared with pathological examination results, color Doppler ultrasonography has a high diagnostic performance for children with moderate and severe congenital hydronephrosis, with an accuracy of 90.91% and 93.18%, respectively, and the kappa values compared with pathological diagnosis were 0.795, 0.862, high concordance; but low diagnostic performance for mild hydronephrosis, with a kappa value of 0.629, the consistency is general.The diagnostic results of intravenous pyelography were mild hydronephrosis in 11 cases, moderate hydronephrosis in 37 cases, and severe hydronephrosis in 40 cases; it has high diagnostic efficiency for children with mild congenital hydronephrosis, with an accuracy of 96.59%, and the kappa value compared with pathological diagnosis was 0.824, which has a high consistency; but the diagnostic performance of moderate and severe hydronephrosis is low, and the kappa value distribution were 0.583 and 0.565, and the consistency is general. The diagnostic accuracy of color Doppler ultrasound combined with intravenous pyelography was 94.32%, which was significantly higher than that of the two methods alone (P＜0.05). Conclusion: Different degree of condition of children with congenital hydronephrosis with different ultrasonic signs, color Doppler ultrasound examination for medium and severe hydronephrosis in children with good diagnostic value,while intravenous pyelography is more effective in diagnosing children with mild hydronephrosis. The combination of the two can improve the diagnostic accuracy of congenital hydronephrosis. [ABSTRACT FROM AUTHOR]