摘要
目的:探讨双源CT多参数在儿童尿酸铵、尿酸以及草酸钙结石成分判断中的应用价值。方法:回顾性分析2018年1月至2023年6月在新疆维吾尔自治区人民医院和新疆维吾尔自治区儿童医院收治的78例符合入选标准的患儿泌尿系结石资料,术后取出结石行红外光谱结石成分分析。离体后的结石建立体外模型行双源CT扫描,获得结石的双源CT多参数进行统计学分析。结果:最终的研究样本78例结石,其中29例(37%)为尿酸铵结石,41例(53%)为草酸钙结石,8例(10%)为尿酸结石。尿酸铵组与尿酸组比较,混合能量CT值、CT值(140 kV)、双能差值、双能比值以及双能量指数值差异均有统计学意义(P均<0.05);草酸钙组与尿酸铵组、尿酸组分别比较,混合能量CT值、CT值(100 kV)、CT值(140 kV)、双能差值、双能比值以及双能量指数值差异均有统计学意义(P<0.001或P<0.05)。受试者操作特征(ROC)曲线分析中,CT值(140 kV)鉴别尿酸铵和尿酸结石效果最好;双能差和双能量指数鉴别尿酸铵和草酸钙结石效果最好;双能差、双能比以及双能量指数鉴别尿酸和草酸钙结石效果最好。结论:儿童泌尿系结石主要以草酸钙和尿酸铵为主,术前行双源CT检查,有助于鉴别尿酸铵、尿酸和草酸钙结石,同时有助于为儿童泌尿系结石的个性化治疗提供重要价值。
Objective:To investigate the value of dual-source CT multi-parameters in identifying the composi-tion of ammonium urate,uric acid,and calcium oxalate stones in children.Methods:A retrospective analysis was conducted on 78 pediatric patients with urinary tract stones who met the inclusion criteria and were treated at People's Hospital of Xinjiang Uygur Autonomous Region and Children's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to June 2023.After surgery,stones were removed and analyzed for composition using infrared spectros-copy.The stones were scanned using dual-source CT in an ex vivo model,and statistical analysis of the CT multi-pa-rameters was performed.Results:A total of 78 stones were included in the study.Among them,29(37%)were am-monium urate stones,41(53%)were calcium oxalate stones,and 8(10%)were uric acid stones.Comparisons be-tween the ammonium urate group and the uric acid group showed statistically significant differences in mixed energy CT values,CT values(140 kV),dual-energy differences,dual-energy ratios,and dual-energy index values(all P<0.05).When comparing the calcium oxalate group with the ammonium urate and uric acid groups,significant differ-ences were found in mixed energy CT values,CT values(100 kV),CT values(140 kV),dual-energy differences,dual-energy ratios,and dual-energy index values(P<0.001 or P<0.05).Receiver operating characteristic(ROC)curve analysis showed that CT values(140 kV)were most effective in differentiating ammonium urate and uric acid stones,while dual-energy difference and dual-energy index were most effective in distinguishing ammonium urate and calcium oxalate stones.Dual-energy difference,dual-energy ratio,and dual-energy index were most effective in differ-entiating uric acid and calcium oxalate stones.Conclusion:Pediatric urinary tract stones are primarily composed of calcium oxalate and ammonium urate.Preoperative dual-source CT scanning helps to differentiate ammonium urate,uric acid,and calcium oxalate stones,providing valuable support for personalized treatment in pediatric patients with urinary tract stones..
作者
刘永祥
艾尼瓦尔·玉素甫
张培新
雷鹏
刘彼得
李九智
杜伟丽
唐琴
刘东
叶尔番·艾尔肯
贾宏亮
Liu Yongxiang;Ainiwaer·Yusufu;Zhang Peixin;Lei Peng;Liu Bide;Li Jiuzhi;Du Weili;Tang Qin;Liu Dong;Yeerfan·Aierken;Jia Hongliang(Graduate School of Xinjiang Medical University,Urumqi 830017,China;Urology Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Radiology Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Urology,Children's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830054,China)
出处
《微创泌尿外科杂志》
2025年第2期84-90,共7页
Journal of Minimally Invasive Urology
基金
新疆维吾尔自治区自然科学基金(2021D01C165)。
关键词
双源CT
泌尿系结石
尿酸铵
结石成分
儿童
dual-source CT
urinary tract stones
ammonium urate
stone composition
children
