肾结石彩色多普勒超声闪烁征的临床研究

Clinical research of twinkling artifact on color doppler sonography in the diagnosis of renal stones

目的 应用彩色多普勒超声检测肾结石的闪烁征与声影情况,分析闪烁征程度与肾结石大小、患者BMI的关系,探讨其对肾结石诊断价值.方法 选取CT平扫确诊为肾结石患者73例,共105个结石.根据闪烁征程度不同将105个结石分为0级组（15个）、1级组（28个）和2级组（62个）.通过CT扫描记录结石的位置、数目、最大径,二维超声观察结石声影情况分为无声影、弱声影、明显声影,采用彩色多普勒超声仪将结石闪烁征程度分为0、1和2级.通过对比3组间结石大小和BMI的情况,探讨肾结石彩色多普勒超声闪烁征的临床意义.结果 ①CT扫描发现直径≤5 mm、5 mm＜直径≤10 mm和直径＞10 mm的结石分别为43、36和26个.二维超声检查显示后方伴明显声影、淡声影和无声影的结石分别为53、19和33个.直径≤5 mm、5 mm＜直径≤10 mm和直径＞10 mm的结石无声影发生率分别为58.1％（25个）、19.4％（7个）和3.8％（1个）.105个结石中有90个结石具有彩色闪烁征.②直径≤5 mm、5 mm＜直径≤10 mm和直径＞10 mm的结石闪烁征0、1和2级组间差别均无统计学意义（x2=1.366,P=0.505）；BMI＜24 kg/m2、24 kg/m2≤BMI＜ 28 kg/m2和BMI≥28 kg/m2患者结石闪烁征0、1和2级组间的差别均无统计学意义（x2=2.405,P=0.300）.结论 肾结石闪烁征程度与结石大小及患者BMI无关.利用闪烁征作为肾结石的诊断指标,可提高较小结石特别直径＜5 mm结石的检出率.

Objective To study the grade of the twinkling artifact and acoustic shadowing with different renal stone size and body mass index （BMI） on doppler sonography,and to evaluate the clinical value of twinkling artifact in the diagnosis of renal stones.Methods With CT as a reference standard,73 patients 105 renal stones were diagnosed.The twinkling artifact and acoustic shadowing in patient were observed.Subjects were grouped as 0 grade （15 renal stones）,1 grade （28 renal stones） and 2 grade （62 renal stones） based on the grade of the twinkling artifact.Correlation of the twinkling artifact grade and the acoustic shadowing appearance in different renal stone size and BMI was assessed.Results According to CT,there were 43,36 and 26 renal stones in the group of smaller than 5 mm,5-10 mm and greater than 10 mm,respectively.53,19,33 renal stones were observed with distinct,indistinct and no acoustic shadowing respectively.Twenty-five renal stones （58.1%）,7 renal stones （19.4%）,1 renal stone（3.8%） had no acoustic shadowing in the group of smaller than 5 mm,5-10 mm and greater than 10 mm,respectively.There were 90 renal stones with twinkling artifact in 105 renal stones.No relation between the twinkling artifact intensity and stone size was found （x2 =1.366,P =0.505）.No relation between the twinkling artifact intensity and BMI was found （x2 =2.405,P =0.300）.Conclusions The twinkling artifact is not influenced by stone size and BMI.It is useful in the diagnosis of renal stones,especially small stones with faint or absent posterior acoustic shadowing.