双源CT多参数比较一水草酸钙结石与混合钙结石的临床价值  

The clinical value of calcium oxalate stone was compared with mixed calcium stone based on dual-source CT

作　　者：谈勤奋 杨婷婷 房昆仑 郝继东[1] Tan Qinfen;Yang Tingting;Fang Kunlun;Hao Jidong(Department of Urology,Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital,Shanghai 201318,China;Department of Radiology,Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital,Shanghai 201318,China)

机构地区：[1]上海健康医学院附属周浦医院泌尿外科,上海201318 [2]上海健康医学院附属周浦医院放射科,上海201318

出　　处：《国际泌尿系统杂志》2021年第1期8-12,共5页International Journal of Urology and Nephrology

基　　金：上海市浦东新区周浦医院护理种子基金项目(ZPHL2017-B5);上海市浦东新区卫计委特色专病项目资助(PWZzb2017-17);上海市卫计委项目资助(201640400)。

摘　　要：目的探讨双源CT多参数比较上尿路一水草酸钙结石与混合钙结石的临床价值,为临床个体化治疗泌尿系结石提供影像学依据。方法回顾性分析2018年1月至2019年6月在本院收治的120例上尿路结石患者的临床资料。按照结石离体行红外光谱分成一水草酸钙组(42例)和混合钙结石组(78例),所有患者术前均行双源CT检查,获得两组结石的双源CT多参数并进行比较。结果一水草酸钙组的双能比、双能指数、原子序数均低于混合钙结石组,而能谱曲线斜率高于混合钙结石组,两组比较差异均有统计学意义(P<0.05);混合钙结石组的结石在不同的单能量CT值比一水草酸钙组低,差异均有统计学意义(P<0.05);双能比对于鉴别一水草酸钙结石与混合钙结石效果最好,特异度为72.2%,敏感度为91.8%,双能量指数、原子序数及能谱曲线斜率也可对两者进行鉴别。结论上尿路结石患者术前行双源CT检查,通过结石CT多参数有助于鉴别上尿路一水草酸钙结石与混合钙结石,有助于为临床医生个体化治疗泌尿系结石提供重要价值。Objective To explore the clinical value of comparing calcium oxalate stones with mixed calcium stones based on dual-source CT.Methods The clinical data of 120 patients with upper urinary calculi from January 2018 to June 2019 were retrospectively analyzed.According to the results of in vitro infrared spectrum analysis of calculi,42 cases were divided into the calcium oxalate group and 78 cases were divided into the calcium oxalate group.All patients underwent preoperative dual-source CT examination,and the dual-source CT multi-parameters of calculi in the two groups were obtained and compared.Results The double energy ratio,double energy index and atomic number in the calcium oxalate group were lower than those in the mixed calcium stone group,while the double energy difference and slope were higher than those in the calcium stone group.There were statistically significant differences in stone dualenergy ratio,dualenergy index,energy spectrum curve slope and atomic number between the two groups(P<0.05).The comparison of different single energy CT values of stones in the two groups showed statistically significant differences(P<0.05).The dualenergy ratio was the best for the identification of calcium oxalate stone and mixed calcium stone,and the dualenergy index,atomic number and energy spectrum curve slope were also different from them,with the specificity of 72.2% and the sensitivity of 91.8%.Conclusions Preoperative dual-source CT examination of patients with upper urinary calculi is helpful to identify different types of calcium calculi through multi-parameter CT examination,which is helpful to provide important value for individual treatment of urinary calculi by clinicians.

关 键 词：尿路结石 肾结石 草酸钙 体层摄影术 螺旋计算机 

分 类 号：R816.7[医药卫生—放射医学] R691.4[医药卫生—临床医学]