多排螺旋CT泌尿系统造影三维重建技术诊断上尿路疾病的ROC分析  

ROC Analysis on the Value of 3-D Reconstruction in Multi-Detector Spiral CT Urography for Upper Urinary Tract Diseases

作　　者：孔维芳[1] 刘荣波[2] 王娜[1] 

机构地区：[1]四川省医学科学院.四川省人民医院放射科,成都610072 [2]四川大学华西医院放射科,成都610041

出　　处：《中国循证医学杂志》2013年第2期143-148,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的采用诊断敏感性及ROC曲线评价多排螺旋CT泌尿系统造影常用三维重建方法诊断上尿路疾病的价值。方法前瞻性收集本院41例上尿路疾病患者,行多排螺旋CT泌尿系统造影(MDCTU)进行MPR、MIP以及VR重建。以金标准为对照,分别采用诊断敏感性指标及ROC曲线评价MDCTU、MPR、MIP及VR对上尿路疾病的诊断价值。结果①该41例患者共有49处上尿路病变。②MPR、MIP及VR对上尿路疾病的定位诊断敏感性分别为48/49(98.0%)、27/49(53.2%)及19/49(38.8%);定性诊断敏感性分别为47/49(95.9%)、17/49(34.7%)及13/49(26.5%);MPR与MIP、VR两者相比,其差异均有统计学意义(P<0.05)。③MPR、MIP及VR鉴别病变良恶性的ROC曲线下面积(AZ值)分别为0.998、0.736及0.669;MPR与MIP、VR两者相比,其差异也均有统计学意义(P<0.05)。④MPR与MDCTU有相同的诊断敏感性及Az值。结论多排螺旋CT泌尿系统造影常用的三维重建方法各有优缺点,其中以MPR的诊断效能最高,其与MDCTU相同,是诊断的基础;而MIP及VR立体感较强。由此可见,综合应用CTU中的三维重建方法对上尿路疾病的诊断及良恶性评估具有重要价值。Objective To evaluate the value of 3-D reconstruction in multi-detector spiral CT urography （MDCTU） for diagnosing upper urinary tract diseases （UUTDs） by means of both diagnostic sensitivity and ROC curve. Meth- ods A total of 41 patients with UUTD were collected. All of them took MDCTU as well as reconstructions including MPR, MIP and VR. Compared with golden standards, the diagnostic value of MDCTU, MPR, MIP and VR were evalu- ated using both diagnostic sensitivity and ROC curve. Results a） A total of 49 upper urinary tract lesions were detected in those 41 patients; b） For UUTD, the localization diagnostic sensitivities of MPR, MIP, and VR were 48/49 （98.0%）, 27/49 （53.2%）, and 19/49 （38.8%）, respectively; while their qualitative diagnostic sensitivities were 47/49 （95.9%）, 17/49 （34.7%）, and 13/49 （26.5%）, respectively; the differences between MPR and the others were significantly （P〈0.05）; c） For distinguishing benign from malignant lesions, the Az value （area under ROC curve） of MPR, MIP, and VR were 0.998, 0.736 and 0.669, respectively; the differences between MPR and the others were significant （P〈0.05）; and d） MPR was complete- ly the same as MDCTU in both diagnostic sensitivity and Az value. Conclusion The common 3-D reconstructions in MDCTU were different in value. MPR is highest in the diagnostic efficiency, which is similar to MDCTU, and is regarded as the basis of diagnosis; while MIP and VR are more stereo and intuitive. So it shows that the comprehensive application of CTU 3-D reconstructions has important value for diagnosing UUTD and distinguishing benign from malignant.

关 键 词：多排螺旋CT泌尿系统造影 三维重建 上尿路疾病 ROC分析 

分 类 号：R691[医药卫生—泌尿科学]