输尿管结石CT征象与自发排出的关系  

Relationship between CT signs and spontaneous expulsion of ureteral calculi

作　　者：余华君 丁辉[1] 赵瑾 骆声福 YU Huajun;DING Hui;ZHAO Jin;LUO Shengfu(Department of Radiology,Zhejiang Hospital,Hangzhou 310013,China;Department of Urinary Surgery,Zhejiang Hospital,Hangzhou 310013,China)

机构地区：[1]浙江医院放射科浙,浙江杭州310013 [2]浙江医院泌尿外科,浙江杭州310013

出　　处：《实用放射学杂志》2023年第9期1478-1481,共4页Journal of Practical Radiology

摘　　要：目的 分析自发排出(SP)与非自发排出(No-SP)输尿管结石并发症的CT特征差异及诊断效能.方法 选取符合诊断标准的 115 例输尿管结石患者进行回顾性分析.根据治疗结果不同,将病例分为SP组和No-SP组,其中SP组 73 例,No-SP组 42 例.比较 2 组CT肾脏周围有无渗出、结石部位输尿管周围有无渗出、肾盂前后径和肾实质相对 CT值的统计学差异,通过受试者工作特征(ROC)曲线检验肾盂前后径和肾实质相对CT值[1/(患/健)]的诊断效能.结果 SP 组肾脏和输尿管周围渗出比例分别为24/73 和 29/73;No-SP组肾脏和输尿管周围渗出比例分别为 17/42 和 32/42.2 组间肾脏周围渗出差异无统计学意义(P>0.05);2 组间输尿管周围渗出差异有统计学意义(P<0.05).SP组肾盂前后径和肾实质相对CT值中位数分别为 1.00 cm、1.10;No-SP 组肾盂前后径和肾实质相对CT值中位数分别为 1.68 cm、1.14.2 组间肾盂前后径和肾实质相对CT值差异有统计学意义(P<0.05).ROC曲线显示肾盂前后径和肾实质相对CT值对 2 组间诊断的曲线下面积(AUC)分别为 0.82、0.62(P<0.05).结论 结石部位输尿管周围渗出、肾盂前后径、肾实质相对CT值是SP与No-SP输尿管结石评估的重要CT征象,有助于早期合适治疗方案的制订.Objective To analyze the differences in CT features and diagnostic efficacy of ureteral calculi complications between spontaneous(SP)and non-spontaneous(No-SP)expulsion.Methods sCT signs of 115 patients with ureteral calculi were selected for retrospective analysis.According to the different treatment results,the patients were divided into SP group(n=73)and No-SP group(n=42).The statistical differences in perirenal exudation and periureteral exudation at the calculi site,anteroposterior diame-ter of the renal pelvis,and relative CT value of renal parenchyma[1/(risk/healthy)] were compared between the two groups.The CT diagnostic efficacy of the anteroposterior diameter of the renal pelvis and relative CT value of renal parenchyma was tested by receiver operating characteristic(ROC)curve.Results The proportions of perirenal and periureteral exudation in SP group were 24/73 and 29/73,while those in No-SP group were 17/42 and 32/42,respectively.There was no significant difference in perirenal exudation between the two groups(P>0.05),however,a significant difference in periureteral exudation was found(P<0.05).The median anteropos-terior diameter of the renal pelvis and relative CT value of renal parenchyma in SP group were 1.00 cm and 1.10,and those in No-SP group were 1.68 cm and 1.14,respectively,which all exhibited significant differences(P<0.05).ROC curve showed that the area under the curve(AUC)values of anteroposterior diameter of the renal pelvis and relative CT value of renal parenchyma for diagnosis in both groups were 0.82 and 0.62,respectively(P<0.05).Conclusion Periureteral exudation,anteroposterior diameter of the renal pelvis,and relative CT value of renal parenchyma are significant CT signs in evaluation of SP and No-SP ureteral calculi,which will be helpful for the early and appropriate treatment planning.

关 键 词：输尿管结石 并发症 计算机体层成像 

分 类 号：R6934[医药卫生—泌尿科学] R814.42[医药卫生—外科学]