泌尿系结石超声测量值的准确性及其影响因素探究

Study on accuracy of measurement and the influential factors with Ultrasound measure urinary tract calculi

目的探讨超声在泌尿系结石诊断中对结石大小测量的准确性及其影响测量的相关因素。方法采用超声测量和CT测量肾、输尿管结石的最大长径,以CT测量值为标准,对两组测值及其差值进行统计学分析,同时就皮肤-结石距离、患者体重指数及结石位置与差值进行相关分析。结果泌尿系结石的平均长径超声测值(9.48±3.63)mm,均大于CT测值(8.44±3.90)mm(P<0.01);其中<5 mm组差值较5～10 mm组及5～10 mm组差值均大(P<0.05);而5～10 mm组与>10 mm组差值的差别无统计学意义(P>0.05);<5mm组与>5 mm组结石超声与CT测值一致率分别为38.9%、93.5%;所有结石测量差值与皮肤-结石距离相关呈正相关性(r=0.904,P<0.01)。结论超声测量高估了泌尿系结石的长径,<5 mm的结石者更为明显;超声测量的准确性与结石-皮肤间的距离有关。

Objective To evaluate the accuracy of measurement and it＇ s influential factors in the diagnosis of urinary tract calculi with Ultrasound. Methods All patients were undergoing abdominal Ultrasound and abdominal non-enhanced helical CT to measure the largest length of renal calculi and ureteral calculi. Abdominal CT measurement was used to the gold standard, and these data were analyzed by statistics. And analyzed statistical relevant about skin-to-stone distance and BMI and stones＇ location with difference of measurement. Results The mean measurement on Ultrasound [ （9.48＋ 3.63 ） mm ] were greater than CT E （ 8.44 ＋ 3.90 ） mm] （ P 〈0. 01 ）. There were statistical significant between group 〈 5 mm and group 5 - lOmm or group 〉 10 mm （P 〈0.05）,but there was no statistical significant between group 5 -10mm and group 〉 10 mm （P 〉 0.05 ） ; The uniform rate of Ultrasound and CT measurement for 〈 5 mm and 〉 5 mm is 38.9% ,95.2% , respec- tively. There was a statistical relevant between difference of measurement and Skin-to-stone distance （r = O. 904 ,P 〈0. 01 ）. The difference of measurement with BMI and stones＇ location were no statistical relevant （ P 〉 0. 05 ）. Conclusion The size of urinary tract calculi were overestimated by Ultrasound, that is obviously for stones 〈 5 mm. There have relationship between accuracy of measurement on ultrasound and Skin-to-stone dis- tance,but no relationship with BMI or stones location.