摘要
目的:本研究旨在探讨双能CT(DECT)能谱曲线分析在泌尿系结石成分鉴别中的诊断效能,为临床精准诊断和个体化治疗提供依据。方法:前瞻性纳入2023年1月至12月就诊于我院的120例泌尿系结石患者。采用GE Discovery CT 750HD进行DECT扫描,通过GE AW4.6后处理工作站进行图像重建与分析。对不同能量水平(40 keV和140 keV)下的CT值进行测量,计算曲线斜率(λHU)、双能比值(DER)和有效原子序数(Zeff),评估各参数的诊断效能。结果:五种结石类型(胱氨酸、草酸钙、尿酸、磷酸钙和磷酸铵镁)在CT值、曲线斜率、双能比值和有效原子序数上均存在显著差异(P<0.001)。草酸钙结石在40 keV时表现出最高的CT值[(1892.36±124.81)HU],尿酸结石最低[(682.47±58.92)HU]。胱氨酸结石的双能比值(2.98±0.23)显著高于其他类型(P<0.05)。有效原子序数在鉴别尿酸结石时表现最佳,AUC达0.938(95%CI:0.871~0.980),敏感度为90.38%,特异度为88.50%。胱氨酸结石双能比值显示出最高的诊断效能,AUC为0.892(95%CI:0.816~0.946)。在识别草酸钙结石时,CT值(40 keV)表现最佳,AUC为0.886(95%CI:0.804~0.941)。结论:DECT能谱曲线分析能够有效鉴别不同类型的泌尿系结石,各项参数在特定结石类型的识别中表现各异。该技术为泌尿系结石的无创成分分析提供了可靠的诊断方法,对指导临床个体化治疗具有重要价值。
Objective:This study aimed to investigate the diagnostic performance of dual-energy CT(DECT)spectral curve analysis in differentiating urinary tract stone compositions,providing a basis for precise clinical diagnosis and individualized treatment.Methods:A prospective study was conducted on 120 patients with urinary tract stones who visited our hospital from January to December 2023.All patients underwent DECT scanning using a GE Discovery CT 750 HD scanner.Images were reconstructed and analyzed using a GE AW4.6 post-processing workstation.CT values at different energy levels(40 keV and 140 keV)were measured,and curve slope(λHU),dual-energy ratio(DER),and effective atomic number(Zeff)were calculated to evaluate their diagnostic performance.Results:Significant differences were observed in CT values,curve slopes,DER and Zeff among five stone types(cystine,calcium oxalate,uric acid,calcium phosphate,and struvite)(P<0.001).Calcium oxalate stones exhibited the highest CT value at 40 keV[(1892.36±124.81)HU],while uric acid stones had the lowest[(682.47±58.92)HU].Cystine stones showed significantly higher DER(2.98±0.23)compared to other types(P<0.05).The Zeff demonstrated optimal performance in identifying uric acid stones,with an AUC of 0.938(95%CI:0.871~0.980),sensitivity of 90.38%,and specificity of 88.50%.The DER showed the highest diagnostic performance for cystine stones,with an AUC of 0.892(95%CI:0.816~0.946).In identifying calcium oxalate stones,CT value(40 keV)performed best,with an AUC of 0.886(95%CI:0.804~0.941).Conclusion:DECT spectral curve analysis can effectively differentiate various types of urinary tract stones,with different parameters showing varying performance in identifying specific stone types.This technique provides a reliable non-invasive method for analyzing stone composition and offers significant value in guiding individualized clinical treatment.
作者
谢开元
刘洋
伍雪婷
XIE Kaiyuan;LIU Yang;WU Xueting(Radiology Department,Neijiang Hospital of Traditional Chinese Medicine,Sichuan 641000,China)
出处
《影像科学与光化学》
2026年第1期52-58,共7页
Imaging Science and Photochemistry
基金
四川省中医药管理局科学技术研究专项课题(2022CP5312)。
关键词
双能CT
能谱分析
泌尿系结石
鉴别诊断
双能比值
dual-energy CT
spectral analysis
urinary tract stones
differential diagnosis
dual-energy ratio
