双源CT双能量成像技术在肾结石定性分析中的应用价值

The Value of Dual-source CT Dual-energy Imaging in the Qualitative Analysis of Kidney Stones

目的:评估双源CT双能量成像技术在肾结石成分分析中的作用。方法:采用双源CT双能量成像技术对96例肾结石患者的离体结石进行扫描。测量80kV及140kV下结石CT值,计算CT值差值、CT值比值、双能量指数(DEI)和断层融合值。采用Kruskal-Wallis H检验及Bonferroni两两比较法对各指标进行统计学分析。结果:草酸钙、尿酸和径基磷灰石结石的CT值差值、CT值比值、DEI和断层融合值的差异均有统计学意义(χ^2=43.474,P<0.001;χ^2=44.958,P<0.001;χ^2=44.813,P<0.001;χ^2=44.872,P<0.001)0双源CT双能量成像技术对草酸钙、尿酸和径基磷灰石结石检测灵敏度分别为97.2%、84.6%、75%,特异度分别为90.5%、98.8%、100%,准确度分别为95.7%、96.8%、97.8%0结论:双源CT双能量成像在离体结石成分分析中准确度高,为DSCT双能量成像应用于结石原位定性诊断提供一定依据。

Purpose:To evaluate the role of dual-energy imaging in the analysis of kidney stone components in the dual-source CT.Methods:Dual-source CT with dual-energy imaging was used in 96 patients with kidney stone.CT value of kidney stone was measured,and CT value difference,CT value ratio,DEI and tomographic fusion were calculated.The Kruskal-Wallis H test with Bonferroni pairwise comparison was used to compare each parameter of different types of kidney stones.Results:There were significant differences for CT value difference,CT value ratio,DEI and tomographic fusion among calcium oxalate,uric acid and hydroxy apatide stones(χ^2=43.474,P<0.001;χ^2=44.958,P<0.001;χ^2=44.813,P<0.001 andχ^2=44.872,P<0.001 respectively).All the values of CT value difference,CT value ratio,DEI and tomographic fusion had good predictive performance between calcium oxalate and uric acid stones.The sensitivity of DSCT with dual-energy imaging for the detection of calcium oxalate,uric acid and hydroxy apatite stones were 97.2%,84.6%and 75%,respectively.The specificity was 90.5%,9&8%and 100%,respectively.The accuracy was 95.7%,96.8%and 97.8%,respectively.Conclusion:DSCT dual-energy imaging technique has a high accuracy in the analysis of isolated kidney stones.It provides a methed for in situ qualitative diagnosis of kidney stones.