东芝640层螺旋CT在泌尿系结石综合诊疗中的临床价值  

Clinical value of Toshiba 640 slice spiral CT in the diagnosis and treatment of urinary calculi

作　　者：陈晓波[1] 张敏红[1] 蔡勇[1] 陈世达[1] 陈伟师 CHEN Xiaobo;ZHANG Minhong;CAI Yong;CHEN Shida;CHEN Weishi(Department of CT,Maoming People's Hospital,Guangdong,Maoming 525000,China)

机构地区：[1]茂名市人民医院CT科,广东茂名525000

出　　处：《包头医学院学报》2018年第7期8-10,共3页Journal of Baotou Medical College

摘　　要：目的:探讨东芝640层螺旋CT对于泌尿系统结石综合诊疗中的临床价值。方法:选取2015年7月至2016年7月间就诊的泌尿系结石患者72例,根据扫描方案差异分为观察组和对照组,分别采取CT血管造影(computed tomography angiography,CTA)联合CT尿道成像(computed tomography urography,CTU)能谱扫描方案、CTA联合CTU普通扫描方案。根据能谱扫描获得的结石有效原子序数值,计算其对结石成分诊断的灵敏度、特异度、阴性预测值、阳性预测值;同时,比较两组患者扫描图像质量评分及辐射剂量。结果:能谱扫描诊断尿酸成分结石、胱氨酸成分结石、磷酸钙成分结石、草酸钙成分结石的敏感性分别为100.0%、80.0%、67.0%、82.4%,特异性分别为100.0%、93.5%、88.9%、94.9%;观察组患者肾动脉CT值、信噪比(signal noise ratio,SNR)、对比噪声比(contrast noise ratio,CNR)等客观评价指标评分及主观评分均较对照组升高(P<0.05);观察组的辐射剂量较对照组降低(P<0.05)。结论:采用东芝640层螺旋CT行CTU联合CTA能谱扫描可有效区分尿酸成分结石、胱氨酸成分结石、磷酸钙成分结石、草酸钙成分结石,为临床治疗提供指导,同时,可提高图像质量并降低辐射剂量。Objective:To investigate the clinical value of Toshiba 640 slice spiral CT in the diagnosis and treatment of urinary calculi.Methods:72 patients with urinary calculi hospitalized from July 2015 to July 2016 were chosen and divided into the observation group and the control group according to the scanning scheme.The observation group received computed tomography angiography(CTA)combined with computed tomography urography(CTU)spectrum scanning scheme and the control group received CTA combined with CTU plain scanning program.According to effective atomic ordinal value with energy spectrum scanning,the sensitivity,the specificity,the negative predictive value and the positive predictive value for diagnosis of calculi were calculated.Meanwhile,the scores of image quality and radiation dose in the two groups were compared.Results:The sensitivity of spectrum scanning in the diagnosis of uric acid stones,cystine stones,calcium phosphate stones and calcium oxalate stones were 100%,80%,67%and 82.4%respectively,and the specificity was 100%,93.5%,88.9%and 94.9%respectively.The objective evaluation index scores(including CT,SNR,CNR)and the subjective scores of image quality of the observation group were significantly higher than those of the control group,the difference being statistically significant(P<0.05);the radiation dose of the observation group was significantly lower than that of the control group(P<0.05).Conclusion:CT combined with CTU and CTA energy spectrum scanning using Toshiba 640 slice spiral can effectively distinguish uric acid stones,cystine stones,calcium phosphate stones and calcium oxalate stones,which can provide guidance for clinical treatment.Meanwhile,it can significantly improve image quality and reduce radiation dose.

关 键 词：能谱扫描 CT血管造影 CT尿道成像 结石成分 辐射剂量 

分 类 号：R691.4[医药卫生—泌尿科学] R816.7[医药卫生—外科学]