本文選題：雙源CT + 雙能量掃描�。� 參考：《第三軍醫(yī)大學(xué)學(xué)報》2015年06期

【摘要】：目的評價雙源CT雙能量掃描體外預(yù)測泌尿系統(tǒng)結(jié)石成分的準(zhǔn)確性。方法對50例泌尿系統(tǒng)結(jié)石患者術(shù)前行雙能量CT掃描,分別測量每枚結(jié)石在80 k V和140 k V成像條件下的CT值、CT值差值和CT值比值。使用雙能量結(jié)石分析軟件預(yù)測結(jié)石成分。收集患者治療后結(jié)石標(biāo)本行紅外光譜儀分析結(jié)石成分,作為金標(biāo)準(zhǔn),運用方差分析比較不同種類結(jié)石之間上述指標(biāo)的差異;評價2種方法檢測結(jié)果的一致性。結(jié)果 50枚結(jié)石中尿酸類結(jié)石有4枚,非尿酸類結(jié)石有46枚(胱氨酸結(jié)石5枚,羥基磷灰石2枚,草酸鈣結(jié)石33枚,混合結(jié)石6枚)。組間兩兩比較,尿酸類結(jié)石與其他結(jié)石的CT值、CT值差值、CT值比值均有統(tǒng)計學(xué)差異(P0.01);草酸鈣結(jié)石和混合結(jié)石與其他結(jié)石的CT值、CT值差值、CT值比值均有統(tǒng)計學(xué)差異(P0.05);其余組間兩兩比較無統(tǒng)計學(xué)差異(P0.05)。與紅外光譜儀分析法結(jié)果比較,雙能量軟件正確診斷4例尿酸類結(jié)石、4例胱氨酸結(jié)石,33例草酸鈣結(jié)石、2例尿酸與草酸鈣混合結(jié)石;另外7例誤診,其中1例胱氨酸結(jié)石和2例羥基磷灰石雙源CT誤診為草酸鈣結(jié)石,4例尿酸與羥基磷灰石混合結(jié)石雙源CT誤診為胱氨酸與羥基磷灰石的混合結(jié)石。雙能量軟件分析結(jié)果與紅外光譜法分析結(jié)果 Kappa一致性檢驗值為0.705,二者具有高度一致性。結(jié)論雙源CT雙能量掃描能準(zhǔn)確區(qū)分尿酸類結(jié)石、胱氨酸類結(jié)石和含鈣結(jié)石,但在區(qū)分含鈣結(jié)石和羥基磷灰石之間以及不同成分的含鈣結(jié)石尚存在困難。
[Abstract]:Objective to evaluate the accuracy of dual-source CT dual-energy scan in predicting the components of urinary calculi in vitro. Methods 50 patients with urolithiasis underwent dual energy CT scan before operation. The CT value difference and CT value ratio of each stone under 80 kV and 140 kV imaging conditions were measured respectively. Dual energy stone analysis software was used to predict the stone composition. After treatment, the stone components were analyzed by infrared spectrometer, and the variance analysis was used to compare the difference of the above indexes among the different kinds of stones, and the consistency of the two methods was evaluated. Results there were 4 uric acid stones and 46 non-uric acid stones (5 cystine stones, 2 hydroxyapatite stones, 33 calcium oxalate stones and 6 mixed stones). Comparison between groups, The difference of CT value and the ratio of CT value between uric acid stone and other calculi were statistically different (P0.01); there was statistical difference in CT value difference between calcium oxalate stone and mixed stone and other calculi (P0.05); the other two groups had different CT value ratio (P0.05). There was no statistical difference (P0.05). Compared with the results of infrared spectrometer analysis, the double energy software was used to correctly diagnose 4 cases of uric acid calculi and 4 cases of cystine calculi (33 cases of calcium oxalate stones), 2 cases of mixed calculus of uric acid and calcium oxalate, and 7 cases of misdiagnosis. One case of cystine stone and two cases of hydroxyapatite double source CT were misdiagnosed as calcium oxalate stone and 4 cases of mixed stone of uric acid and hydroxyapatite were misdiagnosed as mixed stone of cystine and hydroxyapatite. The results of double energy software analysis and infrared spectrum analysis of Kappa consistency test value is 0.705, they are highly consistent. Conclusion Dual-source CT dual-energy scanning can accurately distinguish uric acid stone, cystine stone and calcium stone, but it is difficult to distinguish calcium stone from hydroxyapatite stone and calcium stone with different components.
【作者單位】： 第三軍醫(yī)大學(xué)西南醫(yī)院放射科;解放軍第37醫(yī)院放射科;
【基金】：重慶市自然科學(xué)基金(CSTC2010BB5195)~~
【分類號】：R691.4;R816.7

【參考文獻】

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