The Experimental Study Of Low-dose Furosemide Injection In CT Urography

Background and research purposes: Imaging examination in the diagnosis of urinary system diseases has long been an important position . General imaging methods such as ultrasound, abdominal plain film (KUB), intravenous urography (IVU) and axial CT scans because of their inherent limitations, a single method, limited diagnostic value. Multi-slice spiral CT urography (MDCTU) since in clinical application, with its faster scan speed, high density resolution, rich image processing functions and high diagnostic effectiveness, for the diagnosis and treatment of Urologic Disease provided important information, can be used as a〝one-stop" check for solutions to clinical diagnosis of Urologic Disease [1 ]. Despite the clinical value of MDCTU in many reports have been positive, but it is not without flaws, excretion in patients with normal renal function in renal pelvis, renal and ureteral contrast medium caused by high concentrations of radiation hardening artifact also affected early minor urothelial lesions observation, and ureter full developer rate is not high, particularly the lower urete . This study by animal experiments using diuretics and non-diuretic interventions have multiple sets of images, to analysis, comparison, to seek to improve the quality of MDCTU imaging methods, further improve its efficiency of diagnosis.This research in animal experiments using an agent and the philistines came to an agent in for a collage, analyzing it, is to seek to improve the quality, as MDCTU further improve its efficiency of the diagnosis.Materials and methods In the animal experiments, six healthy dogs weighing between 9 and 11 kg underwent MDCTU, separately by three different methods, each enforcement interval greater than three days. The first group underwent the traditional method of CTU ;The second group received 5mg of intravenous furosemide;The third group received the intravenous administration of 100 ml of normal saline (0.9%).Each goup set of an unenhanced phase and three-phase enhanced scanning.Three groups of CT contrast enhanced were injected by a power injector at a rate of 2 ml/sec ,the amount of 2ml/kg.Obtaining image reconstruction for above 0.625mm cross-sectional image,and then pass on to the station AW4 .4. Made the above image using VR, MPR, MIP, CPR and other methods of renal artery imaging, urinary tract imaging. Respectively to observe the image quality, continuity and urinary tract display contrast medium density, and measurement of related data. All date were analyzed by SPSS13.0 statistical software package, quantitative datas among three groups were tested by one-way ANOVA method, when variance equal with the method of LSD, when variance not equal with Dunnett's T3. Difference with P<0.05 was considered as significant.Results: 1. Urinary system anatomy structure of Furosemide Group CTU display score higher than the other two groups: The average score of Furosemide Group about anatomical structures of the urinary system display was 4.8±0.4 points ; The average score of Traditional Group was 3.0±0.0 points. The average score of Saline Group was 3.3±0.5 points . Anatomy of the urinary system between Furosemide Group CTU and Traditional Group CTU exists significant difference(sp=0.000);Anatomy of the urinary system between Furosemide Group CTU and Saline Group CTU exists significant differences,too(p<0.05). There is no significant difference between Traditional Group CTU and Saline Group CTU(p>0.05). 2. The score of continuity of the urinary system of Furosemide Group CTU is higher than the other two groups . The average score of Furosemide Group about continuity of the urinary system display was 4.5±0.5points, The average score of Traditional Group was 2.6±1.4 points . The average score of Saline Group was 2.7±1.4 points. The scores of continuity of the urinary system between Furosemide Group CTU and Traditional Group CTU exist significant differences(p =0.002) ; The scores of continuity of the urinary system between Furosemide Group CTU and Saline Group CTU exist significant differences,too(p=0.002). There is no significant difference between Traditional Group CTU and Saline Group CTU(p =0.998). 3. CT value in the lumen of the urinary system of Furosemide Group CTU compared with other groups. Mean score of CT value of Furosemide Group CTU: Renal pelvis was 313.67±61.55 Hu;Upper ureter was 302.38±57.72 Hu .Middle ureter was 233.21±68.26 Hu . Distal ureter was 226.54±39.50 Hu . Mean score of CT value of Traditional Group CTU : Renal pelvis was 1062.68±524.17 Hu ; Upper ureter was 1183.71±664.48 Hu ;Middle ureter was 820.49±634.11 Hu ; Distal ureter was 919.50±480.29 Hu . Mean score of CT value of Saline Group CTU: Renal pelvis was 729.94±328.03 Hu;Upper ureter was 719.61±274.24 Hu .Middle ureter was832.58±417.39 Hu . Distal ureter was 680.64±342.41 Hu . Lumen of the segment of Furosemide Group CTU is developing good, CT value of the lumen than other groups was significantly reduced. CT value of the lume between Furosemide Group and Traditional Group exists significant differences(P<0.05);Between Furosemide Group and Saline Group ,there's significant difference,too (P<0.05 ).There's no significant difference between Traditional Group and Saline Group ( p > 0.05 ). 4. Urinary inner diameter of each segment of Furosemide Group CTU compared with other groups.Mean score of maximum number of pipe diameter of Furosemide Group CTU :Upper ureter was 2.6±0.8 mm;Middle ureter was1.8±0.4mm; Distal ureter was 1.9±0.7 mm. Mean score of maximum number of pipe diameter of Traditional Group CTU :Upper ureter was2.4±0.7mm;Middle ureter was1.8±0.6mm . Distal ureter was 1.9±0.6 mm. Mean score of maximum number of pipe diameter of Saline Group CTU : Upper ureter was 2.0±0.6mm;Middle ureter was1.9±0.5mm . Distal ureter was 1.8±0.5 mm. Comparison of statistics: the experimental groups about the ureteral lumen expansion degree difference was not statistically significant( p> 0.05 ). Conclusion: CTU is a relatively new diagnostic imaging examination with solid lesion of display, intuitive, detailed characteristics. Low-dose furosemide injection successfully improves the quality of CT urography, leading to improved distension, contrast material dilution. Scan of image by applying MIP, VR, CPR and other processing technique for analysis, clear observation of urinary micro-structure and a clear diagnosis, image quality is superior to traditional methods of CTU.