泌尿系结石大小与其闪烁伪像相关性的定量研究  

Correlation between stone size and color Doppler twinkling artifact in urinary stones： a quantitative study

作　　者：商蒙蒙 李杰[1] 孙霄[1] 刘青[1] 时丹丹[1] 宁松[1] 刘聪聪[1] 程琳[1] 

机构地区：[1]山东大学齐鲁医院超声科,济南250012

出　　处：《中华超声影像学杂志》2014年第8期717-721,共5页Chinese Journal of Ultrasonography

基　　金：山东省科技发展计划（2012GSF11847）

摘　　要：目的 定量分析泌尿系结石大小与其所产生的闪烁伪像的相关性.方法 采用片剂制药工艺流程制备一水草酸钙、羟基磷灰石、磷酸三钙、L-胱氨酸及尿酸5种成分的泌尿系结石模型,每种均包括10种不同直径（5.0 mm、5.5 mm、6.0 mm、6.5 mm、7.0 mm、7.5 mm、8.0mm、8.5 mm、9.0mm、9.5 mm）.将不同成分、不同直径的结石模型包埋于离体猪肾上极集合系统后行彩色多普勒超声扫查,采集闪烁伪像图像,分别测量闪烁伪像长度（TAL）和宽度（TAW）,并计算闪烁伪像强度（TAI）.结果 所有的结石模型后方均产生了较为明显的闪烁伪像,TAI大小为244.00～11 544.00,平均2 998.80;TAI、TAL、TAW与所有结石模型的直径均呈显著正相关（r分别为0.976、0.940、0.974,P＜0.001）;TAI与TAL、TAW均呈显著正相关（r分别为0.825、0.779,P＜0.001）;多元线性回归分析显示,TAI=-599.48＋ 687.07TAL＋356.97TAW,TAL和TAW是TAI的独立影响因素（标准回归系数β分别为0.555、0.430,P＜0.001）.结论 泌尿系结石所产生的闪烁伪像与结石大小密切相关,随着结石大小的增加,闪烁伪像的强度增加;TAL和TAW是TAI的良好预测指标.Objective To quantitatively analyze the correlation between stone size and color Doppler twinkling artifact in urinary stones.Methods Five types of cylinder urinary stone phantoms （calcium oxalate monohydrate,whitlockite,apatite,L cystine,uric acid） were prepared according to standard pharmaceutical preparation protocols.For each type,stone phantoms of ten different standard diameters were prepared（5.0 mm,5.5 mm,6.0 mm,6.5 mm,7.0 mm,7.5 mm,8.0 mm,8.5 mm,9.0 mm,9.5 mm）.One stone phantom was selected from those artificial stones with the same composition and diameter and embedded in the collecting systems of porcine kidneys in vitro.Color Doppler ultrasound scanning was performed on the stone phantoms.Color pictures with twinkling artifact were recorded.The length of twinkling artifact （TAL） and the width of twinkling artifact （TAW） were measured and the intensity of twinkling artifact （TAI） was calculated.Results All the stone phantoms generated consistently distinguished twinkling artifact.Of all the stone phantoms,TAI was 244.00-11 544.00,2 998.80 in average.TAI,TAL and TAW were significantly correlated with stone diameter （r =0.976,0.940,0.974 respectively,P ＜0.001） for all the stone phantoms.TAI,TAL and TAW increased with increasing stone diameter.TAL and TAW were significantly correlated with TAI （r =0.825,0.779 respectively,P ＜0.001）.Multivariate regression analysis showed that TAI =-599.48 ＋ 687.07TAL ＋ 356.97TAW,TAL and TAW were significant predictive factors for TAI （β =0.555,0.430 respectively,P ＜0.001）.Conclusions The appearance of twinkling artifact is highly dependent on stone size.The intensity of twinkling artifact significantly increased with increasing stone size.TAL and TAW are good predictors of TAI.

关 键 词：超声检查 多普勒 彩色 尿路结石 闪烁伪像 

分 类 号：R691.4[医药卫生—泌尿科学]