摘要:
目的：探讨螺旋CT各参数鉴别尿路结石成分的价值。方法：收集2016年5月至2018年3月我院112例尿路结石患者的术前CT图像资料，测量尿路结石直径（d）、平均CT值（HUm）及CT值标准差（HUsd），并计算平均CT值/直径的比值（HUd），再以术后红外线光谱结果为参照标准，比较各类结石成分d、HUm、HUsd及HUd的差异，并运用受试者工作特征曲线（ROC曲线）评价其鉴别结石成分的效能。结果：尿酸结石21例、一水草酸钙结石49例、碳酸磷灰石10例和混合结石27例，尿酸结石的HUm、HUsd及HUd值均明显低于其他类型结石；尿酸结石与非尿酸结石（一水草酸钙结石、碳酸磷灰石、混合结石）之间的HUm、HUsd及HUd值差异均有统计学意义（P<0.05）；非尿酸结石之间的HUm、HUsd及HUd值差异均无统计学意义（P>0.05）；各类结石的d值差异均无统计学意义（P>0.05）；d、HUm、HUsd及HUd鉴别尿酸结石的ROC曲线下面积（AUC）为0.444、0.915、0.972及0.858。结论：螺旋CT的HUm、HUsd及HUd值均能鉴别尿酸结石和非尿酸结石，其中以HUsd的鉴别效能最佳，但不能区分各类型非尿酸结石。
Abstract:
Objective: The aim of this study is to assess the value of spiral CT parameters in differenting stone composition of urinary tract. Methods: Preoperative CT data of 112 patients with urinary calculi in our hospital from May 2016 to March 2018 were collected. All images were reviewed using abdomen windows to evaluate the following data of stone: the diameter (d), mean CT value (HUm), standard deviation of the mean CT value (HUsd), and the ratio of average CT value/diameter (HUd). The the differences of various stone components were compared for the above factors with statistical methods. Diagnostic performance of the d, Hum, HUsd and HUd for different stone components were measured by receiver operating characteristic curve (ROC curve). Results: There were 21 cases of uric acid stones, 49 cases of calcium oxalate monohydrate, 10 cases of carbonate apatite and 27 cases of mixed stones. The HUm, HUsd and HUd values of uric acid stones were significantly lower than other types of stones, and the difference were statistically significant between uric acid stones and non-uric acid stones (n calcium oxalate stone, carbonate apatite and mixed stones) in HUm, HUsd and HUd values (P<0.05). There were no significant difference in HUm, HUsd and HUd values between non-uric stones (P>0.05). There was no significant difference in the d value of various stones (P>0.05). The area under the ROC curve of d, HUm, HUsd and HUd to identify the stone components were 0.444, 0.915, 0.972 and 0.858, respectively. Conclusion: The HUm, HUsd and HUd values of spiral CT can identify uric acid stones and non-uric acid stones. Among them, HUsd has the best identification efficiency, but it cannot distinguish all types of non-uric acid stones.
百度学术
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