宝石能谱CT混合能量模式检测对泌尿系统结石患者的疗效预测  

Prediction of therapeutic effect of the mixed energy mode detection in gemstone energy spectrum CT on the patients with urinary calculi

作　　者：李杰[1] 孙玮[1] 刘小玲[1] LI Jie;SUN Wei;LIU Xiaoling(Depurtment of Radiology,the Second Afiliated Hos pital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院放射科,河南郑州450000

出　　处：《实用放射学杂志》2023年第1期83-86,共4页Journal of Practical Radiology

摘　　要：目的 探讨宝石能谱CT混合能量模式检测对泌尿系统结石患者的疗效的预测价值.方法 选取接受治疗的228例泌尿系统结石患者,采用宝石能谱CT混合能量模式测量CT值,根据CT值将患者分为高密度组(CT值≥1 000 HU)60例、中密度组(500 HU<CT值<1 000 HU)78例和低密度组(CT值≤500 HU)90例.采用红外光谱分析法分析结石成分,比较3组患者的碎石成功率、结石残留率、碎石清除率,分析CT值对于微创经皮肾镜碎石取石术(PCNL)治疗疗效的预测价值.结果 低密度组的完全排尽率、清石率高于中、高密度组,部分排出率低于中、高密度组(P<0.05).低、中密度组患者的结石主要成分为磷酸铵镁,高密度组患者的结石主要成分为磷酸钙/草酸钙.受试者工作特征(ROC)曲线分析显示,CT值预测治疗成功的曲线下面积(AUC)为0.856[95%置信区间(CI)0.801~0.912],截断值为1 028.36 HU.结论 宝石能谱CT混合能量模式所测CT值与泌尿系统结石患者行PCNL治疗的碎石结石残留率存在正相关性,可根据CT值评估PCNL治疗效果.Objective To explore the value of the mixed energy mode detection in gemstone energy spectrum CT in predicting the therapeutic effect of patients with urinary calculi.Methods 228 patients with urinary calculi who treated were selected.The mixed energy mode of gem stone energy spectrum CT was used to measure the CT values,and according to the CT value,patients were divided into 60 cases in the high-density group(CT value≥1000 HU),78 cases in the medium-density group(500 HU<CT value<1000 HU)and 90 cases in the low-density group(CT value<5oo HU).The components of stones were analyzed by infrared spectroscopy.The success rate of lithotripsy,stone residual rate and lithotripsy clearance rate of the three groups were compared,and the value of CT value in predicting the therapeutic effect of minimally invasive percutaneous nephrolithotomy(PCNL)was analyzed.ResultSs The complete expulsion rate and stone clearance rate of low-density group were higher than those of medium-and high-density groups,and the partial expulsion rate was lower than those of medium-and high-density groups(P<0.05).The main components of stones in low-and medium-density group were magnesium ammonium phosphate,while those in high-density group were calcium phosphate/calcium oxalate.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of CT value successfully predicting treatment was 0.856[95% confidence interval(CI)0.801-0.912],and the cutoff value was 1028.36 HU.Conclusion There is a positive correlation between the CT value of the mixed energy mode in gemstone energy spectrum CT and the residual rate of lithotripsy and stone in patients with urinary calculi who underwent PCNL treatment.The effect of PCNL treatment can be evaluated based on the CT value.

关 键 词：能谱CT 混合能量模式 泌尿系统结石 微创经皮肾镜取石术 疗效 

分 类 号：R814.42[医药卫生—影像医学与核医学] R691.4[医药卫生—放射医学]