在儿童中进行囊泡造影的指示. 形态上的异常和功能上的缺陷
Víctor M García Nieto1, María Candelaria Darias Martin2, Teresa Moraleda Mesa3
1Sección de Nefrología Pediátrica, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, Spain.
Anales de pediatria
|February 24, 2026
概括
基本的功能测试可以帮助确定儿童是否需要尿路感染 (UTI) 后进行囊囊造影. 最大尿度 (UOsm) 对于排除在没有尿路感染史的儿童中严重的膀回流 (VUR) 是有用的.
科学领域:
- 儿科脏病学 儿科脏病学
- 诊断成像 诊断成像 诊断成像
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 在第一次尿路感染后,囊镜和尿路镜是标准的,但现在的指示是临床的.
- 超声波广泛用于评估尿路异常.
- 功能测试可以潜在地改进儿童的囊泡造影指示.
研究的目的:
- 评估基本功能测试在指导儿科患者的囊造影决定中的作用.
- 评估功能测试的诊断准确性,以识别膀管道逆流 (VUR).
主要方法:
- 一项对175名儿童进行超声波检查尿路感染或形态异常的横截面研究.
- 评估的最大尿性 (UOsm),以及尿中的白蛋白/肌素和NAG/肌素的比率.
- 根据骨盆直径定义了显著的形态异常 (SMA).
主要成果:
- 在57名儿童中发现了膀外流 (VUR);56.1%患有SMA,75%患有异常的UOsm.
- "UTI + 显著的SMA"对VUR有89%的负预测值.
- 结合"SMAs或降低最大UOsm"预测了所有严重VUR病例 (等级IV-V).
结论:
- 在患有尿路感染和SMA的儿童中,在囊泡造影之前,可能不需要进行最大UOsm测试.
- 最大UOsm对于排除在没有尿路感染史的儿童中严重的VUR有价值.
- 管功能测试,以及临床和超声波数据,可以优化囊泡造影的指示.
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