双源CT体内预测尿路结石成分的临床应用研究（附40例报告）

张学斌; 李汉忠; 孙昊; 肖河; 刘广华; 张寅生

doi:10.13201/j.issn.1001-1420.2014.02.001

双源CT体内预测尿路结石成分的临床应用研究（附40例报告）

- 1. 中国医学科学院, 北京协和医学院, 北京协和医院泌尿外科(北京, 100730);
- 2. 北京协和医院放射科

详细信息

通讯作者: 李汉忠, E-mail:lihanzhong@medmail.com.cn

中图分类号: R691.4

收稿日期: 2013-12-22

Clinical value of dual-source CT in predicting composition of urinary calculi（An in vivo study and report of 40 cases）

- 1 Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China;
- 2 Department of Radiology, Peking Union Medical College Hospital

More Information

Corresponding author: LI Hanzhong, E-mail: lihanzhong@medmail.com.cn

Received Date: 22 December 2013

摘要

摘要: 目的: 探讨双源CT对体内肾结石化学成分的预测价值。方法: 选择泌尿系结石患者40例,男 30例,女10例;平均年龄46岁。其中肾结石31例,上段输尿管结石9例。采用西门子炫速双源CT(第二代双源CT)(Siemens SOMATOM Definition Flash Dual-source CT,DSCT)进行术前检查,扫描条件采用0.6 mm层厚无间距扫描,所得数据经拆薄重建后传至随机工作站进行重建及双能量分析。所有患者均采用经皮肾镜取石术取得结石样本,采用傅立叶变换红外光谱法分析结石样本成分,进行统计分析,以判断DSCT预测结石成分的准确性。结果: 红外光谱检测单一结石成分12例,混合结石成分28例。与红外光谱分析结果相比,DSCT检测含草酸钙成分结石32例,鉴别草酸钙结石的敏感性为96.8%,特异性为80%。DSCT检测含磷酸盐成分结石32例,鉴别磷酸盐结石的敏感性为96.6%,特异性为63.6%。DSCT检测含尿酸结石5例,鉴别尿酸结石的敏感性和特异性为100%。1例胱氨酸结石的准确率100%。结论: 术前双源CT扫描成分分析能够有效区分尿路结石化学成分,如尿酸结石、草酸盐结石、磷酸盐结石和胱氨酸结石,与红外光谱结石分析结果有较好的一致性。这对于合理选择治疗方式,避免不必要的无效治疗,提高疗效,节省费用,减少并发症等有重要意义,具有临床推广价值。
- 尿路结石 /
- 结石成分 /
- 双源CT /
- 治疗
Abstract: Objective: To explore the clinical value of dual-source CT (DSCT) in predicting chemical component of urinary calculi in vivo.Methods: Forty cases were admitted to Peking union medical college hospital diagnosed with urinary calculi, of which 30 were males, ten were females, with an average age of 46 years old. The stones including 31 cases of kidney stones and nine upper ureteral stones. Siemens SOMATOM Definition Flash Dual source CT (the second generation of DSCT) was used for scanning the patient with 0.6 mm thickness and no-interval. Then the data obtained were transferred to the workstation to be reconstructed and double-energy analyzed. Stone samples were obtained after the percutaneous nephrolithotomy, then the calculi component was analyzed by the Fourier transform infrared spectroscopy. Results: Infrared spectrum analysis showed 12 cases were found only one single calculi substance and 28 cases were found mixed component calculi. DSCT data revealed calcium oxalate calculi could be seen in 32 cases, phosphate stones could be seen in 32 cases, uric acid calculi could be seen in five cases and cystine calculus could be seen in one case. For DSCT the sensitivity and specificity was 96.8% and 80% respecitvely for calcium oxalate calculi, was 96.6% and 63.6% respectively for phosphate stones, 100% for uric acid calculi and cystine calculi.Conclusions: DSCT can effectively differentiate urinary stones components from uric acid, oxalate calculi, phosphate calculi and pure cystine stones. The results from DSCT have a good consistency with the infrared spectrum. Preoperative prediction of the stone component is helpful to choose the appropriate therapy and to prevent the unnecessary invalid treatment, unnecessary costs and damage.
- urinary calculi /
- stone composition /
- dual-source CT /
- therapy

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