双源CT预测泌尿系统结石化学成分的临床价值

发布时间：2018-07-11 15:55

本文选题：双源CT + 双能量扫描　；参考：《第三军医大学学报》2015年06期

【摘要】：目的评价双源CT双能量扫描体外预测泌尿系统结石成分的准确性。方法对50例泌尿系统结石患者术前行双能量CT扫描,分别测量每枚结石在80 k V和140 k V成像条件下的CT值、CT值差值和CT值比值。使用双能量结石分析软件预测结石成分。收集患者治疗后结石标本行红外光谱仪分析结石成分,作为金标准,运用方差分析比较不同种类结石之间上述指标的差异;评价2种方法检测结果的一致性。结果 50枚结石中尿酸类结石有4枚,非尿酸类结石有46枚(胱氨酸结石5枚,羟基磷灰石2枚,草酸钙结石33枚,混合结石6枚)。组间两两比较,尿酸类结石与其他结石的CT值、CT值差值、CT值比值均有统计学差异(P0.01);草酸钙结石和混合结石与其他结石的CT值、CT值差值、CT值比值均有统计学差异(P0.05);其余组间两两比较无统计学差异(P0.05)。与红外光谱仪分析法结果比较,双能量软件正确诊断4例尿酸类结石、4例胱氨酸结石,33例草酸钙结石、2例尿酸与草酸钙混合结石;另外7例误诊,其中1例胱氨酸结石和2例羟基磷灰石双源CT误诊为草酸钙结石,4例尿酸与羟基磷灰石混合结石双源CT误诊为胱氨酸与羟基磷灰石的混合结石。双能量软件分析结果与红外光谱法分析结果 Kappa一致性检验值为0.705,二者具有高度一致性。结论双源CT双能量扫描能准确区分尿酸类结石、胱氨酸类结石和含钙结石,但在区分含钙结石和羟基磷灰石之间以及不同成分的含钙结石尚存在困难。
[Abstract]:Objective to evaluate the accuracy of dual-source CT dual-energy scan in predicting the components of urinary calculi in vitro. Methods 50 patients with urolithiasis underwent dual energy CT scan before operation. The CT value difference and CT value ratio of each stone under 80 kV and 140 kV imaging conditions were measured respectively. Dual energy stone analysis software was used to predict the stone composition. After treatment, the stone components were analyzed by infrared spectrometer, and the variance analysis was used to compare the difference of the above indexes among the different kinds of stones, and the consistency of the two methods was evaluated. Results there were 4 uric acid stones and 46 non-uric acid stones (5 cystine stones, 2 hydroxyapatite stones, 33 calcium oxalate stones and 6 mixed stones). Comparison between groups, The difference of CT value and the ratio of CT value between uric acid stone and other calculi were statistically different (P0.01); there was statistical difference in CT value difference between calcium oxalate stone and mixed stone and other calculi (P0.05); the other two groups had different CT value ratio (P0.05). There was no statistical difference (P0.05). Compared with the results of infrared spectrometer analysis, the double energy software was used to correctly diagnose 4 cases of uric acid calculi and 4 cases of cystine calculi (33 cases of calcium oxalate stones), 2 cases of mixed calculus of uric acid and calcium oxalate, and 7 cases of misdiagnosis. One case of cystine stone and two cases of hydroxyapatite double source CT were misdiagnosed as calcium oxalate stone and 4 cases of mixed stone of uric acid and hydroxyapatite were misdiagnosed as mixed stone of cystine and hydroxyapatite. The results of double energy software analysis and infrared spectrum analysis of Kappa consistency test value is 0.705, they are highly consistent. Conclusion Dual-source CT dual-energy scanning can accurately distinguish uric acid stone, cystine stone and calcium stone, but it is difficult to distinguish calcium stone from hydroxyapatite stone and calcium stone with different components.
【作者单位】：第三军医大学西南医院放射科;解放军第37医院放射科;
【基金】：重庆市自然科学基金(CSTC2010BB5195)~~
【分类号】：R691.4;R816.7

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