双源 CT 双能量技术在泌尿系结石诊断中的应用价值

Application value of dual energy technique of dual source CT in the diagnosis of urinary calculi

目的：探讨双源 CT 双能量技术在尿路结石组成分析中的预测价值。方法对30例泌尿系统结石患者行双源 CT 双能量扫描，对结石组成成份进行分析，将结果与红外光谱法分析的结石组成相比，计算双源 CT 分析尿酸盐结石、非尿酸盐结石的特异度与灵敏度，判断预测结石的准确性。结果30例泌尿系结石中尿酸盐类结石10例，非尿酸盐类结石20例，尿酸盐结石、非尿酸盐结石在140 kV 能量下 CT 值分别为（312.5±55.5）HU、（650.6±255.5）HU，在100 kV 能量下 CT 值分别为（328.5±50.5）HU、（960.8±180.5）HU，尿酸盐结石、非尿酸盐结石在两种能量下的差值分别为（16.5±5.1）HU、（310.2±26.7）HU，比值分别为（1.05±0.01）HU、（1.47±0.02） HU，尿酸盐结石差值、比值明显低于非尿酸盐结石（P 〈0.05），双源 CT 可切确辨别尿酸盐类结石与非尿酸盐类结石，其灵敏度、特异度分别为90%、95%。结论双源 CT 双能量成像技术能在尿路结石治疗前对其组成进行分析，对认识结石的成因及预防结石形成有很大帮助。

Objective To investigate the clinical value of dual source dual energy CT（ DS-DECT）in predict chemical component of urinary calculi. Methods Selected 30 cases with urinary cal-culi underwent dual source Flash CT,analysed the component of the calculi,compared the results and in-frared spectroscopy analysis of calculi composition,calculated the specificity and sensitivity of urate cal-culi,non urate calculus by dual source CT analysis,and judged the forecasting accuracy of the calculi. Results Among the 30 urinary calculi patients,10 cases had uric acid calculi and 20 cases had non-u-ric acid calculi. Uric acid calculi and non-uric acid calculi under 140 kV energy：CT values were （312. 5 ± 55. 5）HU,（650. 6 ± 255. 5）HU;under 100 kV energy：CT values were（328. 5 ± 50. 5）＆amp;nbsp;HU,（960. 8 ± 180. 5）HU;the difference of acid calculi and non-uric acid calculi in the two energy re-spectively was（16. 5 ± 5. 1）,（310. 2 ± 26. 7）HU,ratio was（1. 05 ± 0. 01）,（1. 47 ± 0. 02）,the difference and ratio of uric acid calculi were significantly lower than those in non-uric acid calculi（P 〈0. 05）. Dual source CT can accurately identify uric acid calculi and non-uric acid calculi,the sensitivity and specificity were 90% and 95% . Conclusions Dual source dual energy CT can analyze the urinary calculi composition before treatment,and is helpful to understand the cause of the calculi formation and to prevent the calculi formation.