双源CT对泌尿系结石成分的定性诊断价值评价

The valuation of dual source CT for diagnosis of urinary stone composition

目的探讨双源CT对泌尿系结石成分定性的诊断价值,旨在提高临床诊断的正确率,改善患者的临床疗效。方法选取我院2014年8~12月间因腹痛怀疑泌尿结石收住院的患者53例,对53例疑似泌尿结石患者行双源CT扫描,分析结石成分,与术后结石红外光谱分析结果进行比较,以判断其临床价值。结果双源CT示共42例结石患者,89颗结石,术后红外光谱证实,共有结石患者35例,共有结石66颗。共有结石成分8种,以草酸结石为主,30例患者,59颗（89.4%）结石;其次为尿酸结石3例,4颗（6.2%）,其他结石2例,3颗（4.4%）。双源CT示含草酸钙结石76颗,占全部结石的85.4%（76/89）,光谱证实59颗（77.6%）。双能量扫描显示含草酸钙的准确性95.2%（59/62）,灵敏度100%,特异度61.0%（36/59）,阴性预测值100%。纯草酸钙准确性38.9%（20/59）,灵敏度100%,阴性预测值100%。结论采用双源CT诊断泌尿系结石,在分析体内结石成分方面准确性好,可较好地区分不同组成成分的结石,做出定性判断,有利于为临床治疗提供依据。本组病例草酸结石高达90%左右,与以往研究不同,分析可能与地域、民族、饮食差异有关,有待进一步研究。

Objective To investigate the diagnostic value of dual source CT on urinary stone constituents qualitative, aims to improve the correct diagnosis rate and the clinical curative effect. Methods Selected 53 patients with suspected urinary calculi hospitalized because of abdominal pain in our hospital from August 2014 to December 2014, 53 patients with suspected urinary calculi treated with dual source CT scan, stone composition, compared with stone infrared spectrum analysis results after the operation were analyzed. Results Dual source CT showed a total of 42 cases patients with gallstone, 89 stones, postoperative infrared spectroscopy confirmed that a total of 35 cases of gallstone patients, a total of 66 star stone. There were stone of 8 components, mainly oxalic acid calculi, 30 patients, 59（89.4%） stones; followed by uric acid calculi in 3 cases, 4 （6.2%）, 2 cases of other stones 3 （4.4%）. Dual source CT showed containing calcium oxalate stone 76, accounting for all the stones of the 85.4%（76/89）, spectrum proved that the 59（77.6%）. Du- al energy that contain calcium oxalate （59/62） with accuracy of 95.2%, sensitivity 100%, specificity 61.0%（36/59）, and negative predictive value of 100%. Pure calcium oxalate（20/59） with accuracy of 38.9%, sensitivity of 100%, and negative predictive value of 100%. Conclusion Using dual source CT in diagnosis of urinary calculi in the analysis of the composition of the stones in the body, good accuracy, and can better distinguish the different components of the stone, make the qualitative judgment, in order to provide evidence for clinical treatment. In the group of patients with oxalate stones up to about 90%, different from previous research, analysis may be related to regional, national, differ- ences in diet, pending further study.