DSCT在泌尿系结石成分分析中的应用

Application of DSCT in the analysis of urinary stones

目的比较双源能谱CT(DSCT)双能扫描技术与术后红外光谱技术对尿路结石成分分析的准确性,以期为临床治疗提供指导。方法搜集行二代炫速光子双源能谱CT双能扫描的泌尿系结石患者60例,且60例患者尿路结石均经术后红外光谱对结石成分进行分析。结果 60例患者共发现81枚结石,结石大小不等,最大结石直径0.5~2.8 cm,位置各异,包括肾盂肾盏、输尿管及膀胱结石。其成分各异,双源能谱CT双能结石成分分析显示草酸钙结石、羟基磷灰结石、尿酸结石和混合结石成分的灵敏度为98.6%,特异度为90.9%,阳性预测值为98.6%,阴性预测值为90.9%。对结石成分分析的整体准确性为97.5%。分别测量常见结石草酸钙结石成分CT值和尿酸结石成分CT值,两类成分CT值分别为(980.12±12.54)HU、(356.32±35.23)HU,两者之间CT值有显著差异(P<0.05)。结论双源能谱CT双能扫描技术对尿路结石成分分析具有较高的灵敏度和特异度,准确性高,可术前对结石成分进行准确判断,指导临床治疗。

Objective To compare the accuracy of the dual-source CT dual-energy scanning techniques and postoperative infrared light on urinary stones,and to provide a guidance for clinical treatment.Methods 60 patients with urinary calculi were collected,and the patients were scanned by using lines of the second generation dazzle dual-source CT dual-energy,and calculi ingredient was analyzed by infrared spectrum analysis in the patients with urinary stones.Results A total of 81 calculi were found in 60 patients with varying sizes,with the largest calculi ranging from 0.5~2.8 cm diameter and in the renal pelvis and calyces,ureter and bladder.The components of dual-source CT dual-energy calculi were calcium oxalate calculi,hydroxyphosphorous ash calculi,uric acid calculi and mixed calculi.The sensitivity,specificity,positive predictive value and negative predictive value of the components of calculi were respectively 98.6%,90.9%,98.6%and 90.9%.The overall accuracy of the component analysis of calculi was 97.5%.CT values of common calculi calculi containing calcium oxalate and uric acid calculi were measured respectively,and the CT values of the two components were respectively(980.12±12.54)HU and(356.32±35.23)HU.There was significant difference in CT values between the two components(P<0.05).Conclusion Dual-source CT dual-energy scanning technology has a high sensitivity,specificity and accuracy in the analysis of urinary stone components,which can be used for accurate preoperative judgment of stone components and guide clinical treatment.