泌尿系结石成分的体内双源双能量CT分析

Identification of Urinary Stone Composition with Dual-energy Acquisition of Dual-source CT in Vivo

目的:探讨双源CT双能量技术体内分析泌尿系结石成分的可行性和准确性。方法:104例泌尿系结石患者共113结石纳入研究,全部完成双源CT双能量扫描并于工作站(syngo)上完成结石成分分析,全部结石取出后完成红外线光谱分析确定成分。结果:全部病人均顺利完成体内结石成分分析,以红外线光谱分析为参照标准,双源CT双能量分析显示尿酸、草酸钙和磷灰石成分分别得到准确性97.3%、92.9%、38.1%,灵敏度88.2%、100%、9.6%,特异度99.0%、66.7%、90.0%,阳性预测值93.8%、91.7%、63.6%,以及阴性预测值97.9%、100%、35.3%。胱氨酸盐均为假阳性。结论:双源CT双能量技术分析体内泌尿系结石成分是可行的,对尿酸和草酸钙的定性有很高的准确性,具有较高的临床实用价值。

Purpose： To investigate the clinical value of the determination of renal stone composition in vivo with dual-source dual-energy CT. Methods： One hundred and four cases with 113 renal stones were collected. All cases were scanned with dual-energy acquisition by dual-source CT. The data were sent to the workstation for the analysis of the stone composition. The urinary stones were analyzed by infrared spectroscopy after surgery. These two results were compared and the infrared spectroscopy result was taken as the reference standard. Results： The accuracy, sensitivity, specificity, positive and negative predictive value of the dual-energy CT for the diagnosis of uric acid stone were 97.3%, 88.2%, 99.0%, 93.8%, and 97.9% respectively; those of oxalate were 92.9%, 100%, 66.7%, 91.7%, 100%, and those of apatite were 38.1%, 9.6%, 90.0%, 63.6%, 35.3%. All cystine stones were with false positive results. Conclusion： Dual source dual-energy CT has high accuracy for identifying uric acid and oxalate stone in vivo and can be used clinically.