彩色多普勒闪烁伪像对泌尿系含钙结石诊断价值的实验研究  

Diagnostic value of color Doppler twinkling artifact and in urinary calcium stones：an in vitro experiment

作　　者：刘青[1] 李杰[1] 孙霄[1] 商蒙蒙 时丹丹[1] 宁松[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》2015年第1期70-73,共4页Chinese Journal of Ultrasonography

基　　金：山东省科技发展计划（2012GSF11847）

摘　　要：目的探讨彩色多普勒闪烁伪像对泌尿系含钙结石的诊断及鉴别诊断价值。方法制备一水草酸钙、羟基磷灰石及磷酸三钙三种结石模型，分别包埋于猪肾内进行超声扫查，测量闪烁伪像长度及宽度，计算闪烁伪像强度及声影对比噪声比（C／Nratio），并进行统计学分析。结果所有结石模型均产生闪烁伪像及声影，各成分结石闪烁伪像强度、长度、宽度及声影C／N差异均有统计学意义（P均〈0.01）；各成分结石闪烁伪像强度95％置信区间无重叠，任意两种成分闪烁伪像强度差异有统计学意义（P〈0．05）；一水草酸钙声影C／N和磷酸三钙声影C／N均大于羟基磷灰石声影C／N，差异有统计学意义（P〈0．05）。ROC曲线分析显示，以1127为截断值，闪烁伪像强度诊断为羟基磷灰石的曲线下面积为0．743，诊断敏感性74％，特异性68％，阳性预测值69．8％，阴性预测值72．3％。结论彩色多普勒闪烁伪像可区分泌尿系含钙结石的化学成分，提高了超声定性诊断泌尿系结石的应用价值。Objective To investigate the diagnostic value of twinkling artifact in urinary calcium stones. Methods Calcium oxalate monohydrate, hydroxyapatite and whitlockite stone phantoms were prepared and embedded in porcine kidneys for ultrasound scanning. The length and width of twinkling artifact were measured. The intensity of twinkling artifact and the contrast-to-noise ratio （C/N ratio） of acoustic shadowing were recorded and all the data was analyzed statistically. Results All the stone phantoms generated twinkling artifact and acoustic shadowing. The difference of the intensity, length and width of twinkling artifact and the C/N ratio of acoustic shadowing had statistically significant each composition （P 〈0.01 ）. There was no overlap between 95% confidence interval of the intensity of twinkling artifact for any two compositions, and any two compositions of stones could be differentiated by the intensity of twinkling artifact （ P 〈0.05）. The C/N ratio of acoustic shadowing of calcium oxalate monohydrate and whitlockite stone phantoms were higher than those of hydroxyapatite ones （ P 〈0.05）. The receiver operating characteristic （ROC） curve displayed that the cutoff value of 1 127 of the intensity of twinkling artifact could be used to diagnose hydroxyapatite stones. The sensitivity, specificity, positive predictive value （PPV） ,negative predictive value （NPV） and area under the curve （AUC） were 74% ,68%, 69.8% ,72.3% and 0.743 respectively. Conclusions Twinkling artifact could be used to differentiate the calcium stones, which will be helpful for clinical treatment.

关 键 词：超声检查 肾结石 闪烁伪像 

分 类 号：R445.1[医药卫生—影像医学与核医学]