非增强螺旋CT平扫对上尿路结石成分预测的体内研究  

Determination of chemical composition of upper urinary calculi by reformatted unenhanced spiral CT in vivo

作　　者：艾合买提·卡德尔[1] 阿不都米吉提·阿不都克力木 汪清[1] 

机构地区：[1]新疆维吾尔自治区人民医院泌尿二科,新疆乌鲁木齐830001 [2]乌鲁木齐新疆维吾尔自治区中医医院泌尿外科,新疆830001

出　　处：《国际泌尿系统杂志》2017年第1期56-58,共3页International Journal of Urology and Nephrology

摘　　要：目的 探讨非增强螺旋CT对体内上尿路结石化学成分的预测价值.方法 回顾性分析156例有结石标本的上尿路结石患者临床资料.所有患者在治疗前采用GE High speed CT/i螺旋CT机行非增强结石扫描,扫描参数为120 kV,320 mA,螺距0.6：1,扫描层厚为5 mm.在CT软组织窗测量结石平均CT值.将获取的结石样本采用红外光谱自动分析系统进行化学成分定性分析.经统计学分析,找出各种成分结石的相应CT值范围.结果 非增强螺旋CT扫描156例结石的软组织窗CT值范围为128～ 1663亨氏单位（hounsfield unit,HU）.共发现纯结石57例,其中纯一水草酸钙结石28例,纯尿酸结石19例,纯羟基磷灰石10例,混合结石99例.一水草酸钙、尿酸、羟基磷灰石三种纯结石的软组织窗平均CT值分别为（915.4±142.9） HU、（469.7±55.1） HU、（868.4±168.8）HU.尿酸结石与一水草酸钙结石、尿酸结石与羟基磷灰石之间的CT值差异有统计学意义（P＜0.05）.19例纯尿酸结石和137例其他成分结石的软组织窗平均CT值之间差异有统计学意义（P＜0.05）.以结石的软组织窗平均CT值＜ 550 HU为标准诊断纯尿酸结石,其灵敏度为92.8％,特异度为98.1％,阳性预测值为88.5％,阴性预测值为99％,诊断符合率为98.1％.结论 非增强螺旋CT平扫用于判断上尿路结石成分效果满意.根据软组织窗CT值不同,可将体内尿酸结石与其他成分结石区分.软组织窗平均CT值＜550 HU可作为纯尿酸结石的诊断标准.Objectives To investigate the value of reformatted unenhanced spiral CT in predicting the chemical composition of upper urinary stones in vivo.Methods The clinical data of 156 cases with calculi specimen of upper urinary tract were analyzed retrospectively.All of the patients were visualized on reformatted unenhanced spiral CT before stone removal.Unenhanced spiral CT was performed by General Electric（GE）,high-speed CT/i CT scanner.The average CT-attenuation value was evaluated by soft-tissue window.All chemical qualitative analysis of stones was analyzed by analysis system of infrared spectrum.After statistics analysis,the corresponding CT value range of various composition stone minerals was found.Results 156 cases of reformatted unenhanced spiral CT value were 128 ～ 1663 HU.The 57 pure stones were divided into three groups and included 28 cases of calcium oxalate monohydrate,19 cases of uric acid,10 cases of pure hydroxyapatite.99 cases of mixed stones were found.In the analysis of pure stones,the mean CT value of stones composed of calcium oxalate monohydrate,uric acid and pure hydroxyapatite was （915.4 ± 142.9）,（469.7 ± 55.1）,（868.4 ± 168.8） HU,respectively.There was statistically significant difference in CT value among the uric acid and calcium oxalate monohydrate stones and hydroxyapatite （P ＜ 0.05）.The analyses showed that the 19 cases of uric acid calculi could be distinguished from calcium oxalate monohydrate and hydroxyapatite stones.A statistically significant difference was found between uric acid stones and other stones by the average CT-attenuation in soft-tissue window（P ＜ 0.05）.Conclusions Reformatted unenhanced spiral CT would be examined urinary calculi,and the result is satisfactory.The initial clinical study demonstrated that we would be able to difference between pure uric acid and other stones in vivo according the average CT-attenuation value in soft-tissue window of urinary calculi from reformatted unenhanced spiral CT.An average CT-attenuation value in s

关 键 词：尿路结石 体层摄影术 X线计算机 

分 类 号：R691.4[医药卫生—泌尿科学]