摘要
目的探讨结石CT值在输尿管结石成分定性诊断及体外冲击波碎石术(ESWL)疗效评估中的应用价值。方法纳入190例输尿管结石患者,其中小结石(直径<10 mm) 107例,大结石(直径≥10 mm) 83例。术前采用双能CT测定结石的CT值并计算AR值,根据AR值将患者分为低密度结石组64例、中密度结石组83例、高密度结石组43例。以术后采用红外光谱法的诊断结果,评价CT值诊断结石成分的效能。比较不同组间ESWL的疗效及并发症发生情况。结果 CT值对结石成分的诊断符合率为97. 9%(186/190),与红外光谱法的诊断结果一致性较高(Kappa值=0. 971,P <0. 05)。对于直径<10 mm的小结石,低密度、中密度、高密度结石组的ESWL次数依次升高(均P <0. 05)。对于直径≥10 mm的大结石,低密度、中密度、高密度结石组的ESWL次数均依次升高,而结石清除率依次降低(均P <0. 05),中密度、高密度组石街形成率均高于低密度结石组(P <0. 05)。高密度结石组ESWL术后肉眼血尿的发生率高于低密度组(P <0. 05)。结论结石CT值在定性判断结石成分中具有较高的价值,且有助于评估ESWL的术后疗效以及并发症发生情况。
Objective To explore the application value of CT value of calculi in the qualitative diagnosis of ureteral calculi composition and efficacy evaluation of extracorporeal shock-wave lithotripsy( ESWL). Methods A total of 190 patients with ureteral calculi were enrolled in the study,including 107 with small calculi having a diameter < 10 mm,and 83 with larger calculi having a diameter ≥10 mm. Dual-energy CT was used to determine the CT values of calculi and AR values were calculated,then the patients were divided into low-density calculi group( 64 cases),medium-density calculi group( 83 cases),high-density calculi group( 43 cases) according to the AR value. The efficiency of CT value for diagnosing the composition of calculi was assessed using the diagnostic results of infrared spectroscopy after operation. The efficacy and complications of ESWL were compared between different groups. Results The diagnostic coincidence rate of CT value for the composition of calculi was 97. 9%( 186/190),which was highly consistent with the diagnostic results of infrared spectroscopy( Kappa value,0. 971; P < 0. 05). For small calculi with a diameter < 10 mm,the frequencies of ESWL increased in turn in the low-density calculi group,the medium-density calculi group and the high-density calculi group( all P < 0. 05). For large calculi with a diameter≥10 mm,the frequencies of ESWL increased in turn in the low-density calculi group,the medium-density calculi group and the high-density calculi group,whereas the clearance rates of calculi decreased in turn( all P < 0. 05),the incidence rate of steinstrasse in the medium-density calculi group or the high-density calculi group was lower than that in the low-density calculi group( P < 0. 05). The incidence rate of post-ESWL gross hematuria in the high-density calculi group was higher than that in the low-density group( P < 0. 05). Conclusion CT value of calculi is of great value in the qualitative judgment of calculi composition and is helpful to evaluate the postoperative efficacy and complications of ESWL.
作者
奚雪滔
赵树田
赵雪
张瑜
杨登科
杜广
XI Xue-tao;ZHAO Shu-tian;ZHAO Xue;ZHANG Yu;YANG Deng-ke;DU Guang(Department of Urology,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200336,China)
出处
《广西医学》
CAS
2018年第23期2802-2805,共4页
Guangxi Medical Journal
关键词
结石CT值
结石成分
体外冲击波碎石术
输尿管结石
疗效
评价
诊断
CT value of calculi
Calculi composition
Extracorporeal shock-wave lithotripsy
Efficacy
Evaluation
Diagnosis
