摘要
目的探讨低剂量非增强螺旋CT在急诊肾绞痛中的诊断价值。方法对123例急性腰腹部绞痛而怀疑泌尿系结石患者,根据体质量指数行低剂量非增强螺旋CT检查,并同时行泌尿系超声和KUB平片检查作对照。结果103例确诊为泌尿系结石,其中25例自行排出,45例体外碎石后排出,33例行输尿管镜碎石。低剂量非增强螺旋CT诊断泌尿系结石100例;超声诊断泌尿系结石77例;KUB诊断泌尿系结石68例,5例假阳性。低剂量非增强螺旋CT、超声和KUB的敏感度分别为100%、74.8%、66.1%,特异度分别为100%、100%、75%,阳性预测值分别为100%、100%、93.1%,阴性预测值分别为86.9%、43.5%、30.0%,约登指数分别为0.97、0.75、0.41。CT与超声组对比2=21.23,P=0.000,两种方法差别具有显著性。CT与KUB组对比2=33.04,P=0.000,两种方法差别具有显著性。结论低剂量非增强螺旋CT诊断泌尿系结石比超声和KUB具有更高的敏感度和特异度,且降低了患者的辐射剂量,可作为临床怀疑泌尿系结石、尤其是急性肾绞痛患者的常规检查方法。
Objective To compare the value of low-dose noncontrast helical CT （NCHCT）, US and KUB in detecting u- rinary calculi. Methods A total of 123 patients with acute renal colic were evaluated with low-dose NCHCT, US and KUB for detection of urinary calculi. Results 103 patients were proved as urolithiasis, low-dose NCHCT revealed 100 calculi, US demonstrated 77 calculi, KUB demonstrated 68 calculi, and 5 were false positive. Sensitivity of low-dose NCHCT, US and KUB was 100%, 74.8%, 66. 1%, respectively, specificity of low-dose NCHCT, US and KUB was 100%, 100%, 750%, respectively. Positive predictive value was 100%, 100%, 93.1 % and negative predictive value was 86.90%, 43.5%, 30.0%, respectively. Youden index was 0.97, 0.75, 0.41, respectively. Differences in accuracy of low- dose NCHCT and US were statistically significant （X2 = 21.23, P =0. 000）, so were NCHCT and KUB （x2 = 33.04, P = 0. 000）. Conclusion Low-dose NCHCT is more accurate than US and KUB in detecting urinary calculi and the radiation dose is significantly decreased. Low-dose NCHCT is the imaging method of choice in the assessment of patients with acute renal colic.
出处
《医学影像学杂志》
2014年第2期257-260,共4页
Journal of Medical Imaging
基金
厦门市医学中心重点学科建设基金〔厦卫科教中医(2006)271号〕
