双源CT在尿路结石成分分析中的临床研究  

Analysis of Urinary Calculi Composition by Dual Source CT

作　　者：巢海潮 曾涛[2] 鲍坤旺[2] 孟栋良[2] 黄海鹏[2] 包佑根[2] 毛允义[2] 朱心燊[2] 

机构地区：[1]南昌大学研究生院医学部 [2]江西省人民医院泌尿外科,南昌330006

出　　处：《实用临床医学（江西）》2014年第3期39-41,51,共4页Practical Clinical Medicine

基　　金：江西省科技厅支撑计划(20111122070158)

摘　　要：目的探讨双源CT(DSCT)双能量技术应用于尿路结石成分分析中的临床价值。方法对75例尿路结石患者行DSCT双能量扫描及血清尿酸测定,对其结石成分进行分析,将结果与采用红外光谱法分析结石成分的结果作对比,计算DSCT在体分析尿酸盐结石及非尿酸盐结石的灵敏度与特异度。结果 75例结石标本中尿酸盐结石25例,在140 kV能量下的CT值为(316.3±64.5)HU,在80 kV能量下的CT值为(336.4±55.7)HU;非尿酸盐结石为50例,在140 kV能量下的CT值为(680.7±334.1)HU,在80 kV能量状态下为(1 005.2±221.3)HU。尿酸盐结石在2种能量状态下差值、比值分别为(20.1±8.1)、(1.06±0.02)HU;非尿酸盐结石在2种能量状态下差值、比值分别为(324.6±31.2)、(1.48±0.03)HU,尿酸盐结石差值、比值均明显低于非尿酸盐结石(均P<0.05)。DSCT能准确地区分尿酸盐结石和非尿酸盐结石,灵敏度及特异度分别为88.0%及98.0%。结论 DSCT能准确地区分尿酸盐结石和非尿酸盐结石。使用DSCT双能量技术在治疗前对尿路结石的成分进行初步分析,对了解结石成因、预防结石形成及指导治疗具有重要的意义。Objective To assess the clinical value of dual-source dual-energy CT in the analysis of urinary calculi composition. Methods Dual-source dual-energy CT was performed and serum uric acid was determined to analyze the composition of urinary calculi in 75 patients with urinary calculi. The results were compared with the results of Fourier transform infrared spectrometry （FTIR）. The sensitivity and specificity of dual-source dual-energy CT were calculated in the evaluation of the composition of uric acid calculi and non-uric acid calculi. Results Among the 75 patients, 25 had uric acid stones and 50 had non-uric acid stones. CT values at 140 kV and 80 kV were, respectively, （316.3±64.5） and （336.4±55.7） HU for uric acid calculi, and （680.7±334.1） and（1 005.2±221.3）for non-uric acid calculi. The 80 kV-140 kV difference and 80 kV/140 kV ratio for uric acid calculi （20.1 ±8.1 and 1.06 ±0.02, respectively） were significantly lower than those for non-uric acid calculi （324.6 ±31.2 and 1.48 ±0.03, respectively） （P＆lt;0.05）. Dual-source dual-energy CT could accurately distinguish uric acid stones and non-uric acid stones. The sensitivity and specificity were 88.0% and 98.0,respectively. Conclusion Dual-source dual-energy CT can preliminarily analyze the composition of urinary calculi and accurately distinguish uric acid stones and non-uric acid stones before treatment. Therefore, the application of dual-source dual-energy CT has significant importance to understand the causes of stone formation and to prevent and treat urinary calculi in patients with urinary calculi.

关 键 词：双源CT 体层摄影术 X线计算机 尿路结石 红外光谱法 

分 类 号：R69[医药卫生—泌尿科学] R445.3[医药卫生—外科学]