超声联合CT在输尿管末端结石诊断及治疗中的应用  

Ultrasound combined with CT in the diagnosis and treatment of distal ureteral calculi

作　　者：谢文卫 Xie Wenwei(Department of Ultrasound,Changzhou Xinbei District Benniu People's Hospital,Changzhou 213000,China)

机构地区：[1]常州市新北区奔牛人民医院超声科,常州213000

出　　处：《现代仪器与医疗》2025年第1期83-87,共5页Modern Instruments & Medical Treatment

摘　　要：目的探析在输尿管末端结石诊断和治疗中应用超声联合CT的临床价值。方法回顾性分析2022年1月—2024年5月在常州市新北区奔牛人民医院接受诊断和手术治疗的103例输尿管结石患者的临床资料,术前所有患者分别行超声和CT探查,统计所有患者超声和CT单一诊断与联合诊断以及手术病理检出结石位置情况,计算超声和CT单一诊断和联合诊断与手术病理检出结果的一致性,并以手术病理结果为金标准,计算超声和CT单一或联合诊断输尿管末端结石的效能。同时,在术后1周所有患者复查超声和CT观察结石清除效果。结果经K_(appa)一致性检验评价超声单一诊断与手术病理结果一致性中等(K_(appa)=0.607),CT单一诊断与手术病理结果高度一致(K_(appa)=0.657),超声联合CT诊断与手术病理结果完全一致(K_(appa)=0.947)。经计算,CT单一诊断输尿管末端结石的准确率、灵敏度、特异度较高于超声单一诊断,但是组间差异无统计学意义(P>0.05);超声联合CT诊断输尿管末端结石的准确率和灵敏度均显著高于超声和CT单一诊断,组间比较存在统计学意义(P<0.05);超声联合CT诊断输尿管末端结石的特异度较高于超声和CT单一诊断,但是组间差异无统计学意义(P>0.05)。经手术病理确诊为输尿管末端结石的103例患者术后1周复查超声显示,术前探查到输尿管内强回声团均消失,且未探见输尿管扩张及腔内液体回声;103例患者术后1周复查CT显示,术后患者输尿管腔内高密度灶以及输尿管扩张征象均消失,并未探查到肾积水、梗阻性肾实质像。根据超声和CT探查结果评估结石清除率达100.00%。结论在输尿管末端结石诊断中应用超声和CT辅助诊断的效能良好,两项影像学技术联合诊断则可进一步提高诊断的准确率和灵敏度,减少漏诊情况的发生,并且在术后通过复查超声和CT可以对其结石清除情况进行评估,为临床诊疗�Objective To explore the clinical value of ultrasound combined with CT in the diagnosis and treatment of distal ureteral calculi.Methods Clinical data of 103 patients with ureteral calculi who received diagnosis and surgical treatment in Benniu People's Hospital,Xinnorth District,Changzhou City from January 2022 to May 2024 were retrospectively analyzed.Ultrasonography and CT exploration were performed on all patients before surgery,and the single diagnosis and combined diagnosis of ultrasonography and CT as well as the location of calculi detected by operation and pathology were analyzed.The consistency of single diagnosis and combined diagnosis of ultrasound and CT with surgical pathological findings was calculated,and the efficacy of single or combined diagnosis of ultrasound and CT in the diagnosis of distal ureteral calculi was calculated using surgical pathological results as the gold standard.At the same time,all patients were re-examined by ultrasound and CT one week after surgery to observe the effect of stone removal.Results According to kappa consistency test,the consistency of single ultrasound diagnosis and surgical pathological results was moderate(K_(appa)=0.607),the single CT diagnosis and surgical pathological results were highly consistent(K_(appa)=0.657),and the diagnosis of ultrasound combined with CT was completely consistent with surgical pathological results(K_(appa)=0.947).After calculation,the accuracy,sensitivity and specificity of CT single diagnosis of ureteral calculi were higher than those of ultrasound single diagnosis,but there was no significant difference between the two groups(P>0.05).The accuracy and sensitivity of ultrasound combined with CT in the diagnosis of distal ureteral calculi were significantly higher than those of ultrasound and CT alone(P<0.05).The specificity of ultrasound combined with CT in the diagnosis of distal ureteral calculi was higher than that of ultrasound and CT alone,but there was no significant difference between the two groups(P>0.05).One week after

关 键 词：超声 CT 输尿管末端结石 诊断 治疗 

分 类 号：TH77[机械工程—仪器科学与技术] R699.2[机械工程—精密仪器及机械]