双源CT预测泌尿系统结石化学成分的临床价值

黎川; 傅强; 梁勇; 王新; 王庆; 赵骏; 周代全

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双源CT预测泌尿系统结石化学成分的临床价值

论著 | 更新时间：2026-01-09

- 双源CT预测泌尿系统结石化学成分的临床价值
- Clinical analysis on predictive value of dual-source CT scanning for urinary stone composition
- 陆军军医大学学报 2015年37卷第6期页码：568-572
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  中图分类号： R362;R691.404;R814.42
- 纸质出版：2015
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黎川,傅强,梁勇,王新,王庆,赵骏,周代全.双源CT预测泌尿系统结石化学成分的临床价值[J].陆军军医大学学报(原第三军医大学学报),2015,37(06):568-572.

　Li Chuan,Fu Qiang,Liang Yong,Wang Xin,Wang Qing,Zhao Jun,Zhou Daiquan.Clinical analysis on predictive value of dual-source CT scanning for urinary stone composition[J].J Amry Med Univ (J Third Mil Med Univ),2015,37(06):568-572.
黎川,傅强,梁勇,王新,王庆,赵骏,周代全.双源CT预测泌尿系统结石化学成分的临床价值[J].陆军军医大学学报(原第三军医大学学报),2015,37(06):568-572. DOI：

　Li Chuan,Fu Qiang,Liang Yong,Wang Xin,Wang Qing,Zhao Jun,Zhou Daiquan.Clinical analysis on predictive value of dual-source CT scanning for urinary stone composition[J].J Amry Med Univ (J Third Mil Med Univ),2015,37(06):568-572. DOI：

摘要

目的评价双源CT双能量扫描体外预测泌尿系统结石成分的准确性。方法对50例泌尿系统结石患者术前行双能量CT扫描，分别测量每枚结石在80 kV和140 kV成像条件下的CT值、CT值差值和CT值比值。使用双能量结石分析软件预测结石成分。收集患者治疗后结石标本行红外光谱仪分析结石成分，作为金标准，运用方差分析比较不同种类结石之间上述指标的差异；评价2种方法检测结果的一致性。结果 50枚结石中尿酸类结石有4枚，非尿酸类结石有46枚(胱氨酸结石5枚，羟基磷灰石2枚，草酸钙结石33枚，混合结石6枚)。组间两两比较，尿酸类结石与其他结石的CT值、CT值差值、CT值比值均有统计学差异(P0.01)；草酸钙结石和混合结石与其他结石的CT值、CT值差值、CT值比值均有统计学差异(P0.05)；其余组间两两比较无统计学差异(P0.05)。与红外光谱仪分析法结果比较，双能量软件正确诊断4例尿酸类结石、4例胱氨酸结石，33例草酸钙结石、2例尿酸与草酸钙混合结石；另外7例误诊，其中1例胱氨酸结石和2例羟基磷灰石双源CT误诊为草酸钙结石，4例尿酸与羟基磷灰石混合结石双源CT误诊为胱氨酸与羟基磷灰石的混合结石。双能量软件分析结果与红外光谱法分析结果Kappa一致性检验值为0.705，二者具有高度一致性。结论双源CT双能量扫描能准确区分尿酸类结石、胱氨酸类结石和含钙结石，但在区分含钙结石和羟基磷灰石之间以及不同成分的含钙结石尚存在困难。

Abstract

Objective To evaluate the forecasting accuracy of dual-energy CT scanning to differentiate different compositions of urinary stone in vivo. Methods Fifty patients with known urinary stone disease admitted in the Southwest Hospital from March 2011 to September 2012 were enrolled in this study. They all underwent scanning preoperatively using a DSCT scanner in the dual-energy mode. CT value

CT different value and CT ratio value of each stone were recorded for the 80 kV and the 140 kV datasets. Based on dual energy software

stone composition was predicted. And these stone samples collected through surgery were analyzed by the infrared spectroscopy as the gold standard. ANOVA was used to compare CT value

CT value difference and CT ratio value of different stone compositions. Meanwhile

the 2 different methods were assessed by Kappa analysis to study their consistency. Results Among 50 stones

there were 4 cases of uric acid (UA) stones and 46 cases of non-UA acid ones (5 cystine

2 hydroxyapatite

33 CaOx stone

and 6 mixed stones). There were statistical differences in CT value

CT difference value and CT ratio value

compared UA stones with other stones (P＜0.05). But such differences were seen among the cystine

hydroxyapatite

CaOx

and mixed stones (P0.05). Compared the results analyzed by infrared spectrometer

dual energy software correctly diagnosed 4 cases of UA stones

4 of cystine stones

33 of CaOx stones

and 2 of mixed stones of UA and CaOx

but misdiagnosed 7 cases

including 1 case of cystine stone and 2 of hydroxyapatite stones misdiagnosed as CaOx stones

and 4 of mixed stones of UA and hydroxyapatite misdiagnosed as mixed ones of cystine and hydroxyapatite. Kappa analysis that the dual energy software and infrared spectroscopy had a test value of 0.705

indicating high consistency. Conclusion Dual-source dual-energy CT scanning has the ability to differentiate UA stones

cystine stones and calcium stones

but it can not distinguish subtypes of calcium stones and hydroxyapatite stones.

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