CT对输尿管小结石的诊断价值

The capability of non-contrast CT scan for diagnosing small ureteral stones

目的评价CT平扫对输尿管小结石的诊断能力。方法78例经输尿管镜取石或服用溶石性药物证实为输尿管小结石(直径小于5mm)患者均经CT平扫,其诊断准确率与B超及X线腹部平片检查相对照。结果78例输尿管小结石病例中,48例在右侧,30例在左侧。B超、X线平片和CT平扫对输尿管小结石的诊断准确性分别为35.8%(28/78),30.7%(24/28)和98.7%(77/78)。结论CT平扫是目前诊断输尿管小结石的最准确方法,它对观察继发性改变和指导临床治疗,尤其对选择输尿管镜取石术镜头入路方向有重要价值。

Objective To evatuate the capability of non-contrast CT scan for diagnosing small ureteral stones.Methods Seventy eight patients with small (< 5 mm in diameter)ureteral stones those were demonstrated by ureteroscopic removal of the stones and administration of litholytic drugs underwent non-contrast CT scans,in same time,the diagnostic accuracy of CT was compared with that of ultrasound and X-ray plain abdominal film.Results Among 78 patients with small ureteral stones,48 cases had stones on the right side,and 30 had stones on the left side.The diagnostic accuracy of small ureteral stones was 35.8 %(28/78) for ultrasound,30.7 %(24/78) for X-ray plain film,and 98.7 %(77/78)for non-contrast CT scans,respectively.Conclusion Non-contrast CT is now the most accurate modality in the diagnosis of patients with small ureteral stones and it has important value for observing the secondary changes of ureteral stone and for guiding the clinical therapy,especially,for selecting the insertion path of lens during ureteroscopic lithocenosis.