The value of CT value in predicting stone composition of upper urinary calculi and extracorporeal shock wave lithotripsy treatment
Objective To study the value of CT value in predicting the composition of upper urinary calculi and in the treat-ment of extracorporeal shock wave lithotripsy(ESWL).Methods 150 patients with upper urinary tract stones treated with ESWL were included,and all of them underwent CT examination to record the CT values of stones at HU80kV and HU140kV respectively,and the differ-ence of HU,the HU ratio and the dual energy index(DEI)were calculated,the composition of stones using the dual energy software was characterized,and took the specimens of stones for infrared spectroscopy analysis after the completion of the treatment to compare the re-sults of the CT examination of the stones with different compositions.After treatment,the stone samples were taken for infrared spectrum analysis to compare the results of CT examination of stones with different components,and infrared spectral analysis was used as the gold standard to analyze the predictive efficacy of CT dual-energy imaging on stone composition.The patients were followed up 12 weeks after ESWL treatment to evaluate the lithotripsy effect of ESWL on stones with different CT values(Hu＜800 and HU ≥800)and CT dual-energy qualitative,and to statistically assess the adverse reactions after lithotripsy at different CT values.Results The results of infrared spectrum analysis showed that among 150 patients with upper urinary tract stones,there were 72 cases of single stones and 68 cases of mixed stones,and the differences in HU difference,HU ratio and DEI of stones with different components were statistically significant(P＜0.05).Compared with the results of infrared spectrum analysis,the sensitivity and specificity of CT dual-energy imaging in predic-ting stones were in the uric acid stones group(92.86％,100.00％),cystine stones(50.00％,97.97％),ammonium magnesium phos-phate stones group(100.00％,97.22％)and calcium oxalate stones group(94.12％,94.95％),mixed uric acid group(88.89％,95.74％),mixed calcium-containing stone group(91.18％,95.12％).The impact times of patients with Hu＜800 were lower than those of patients with HU ≥800,and the crushing and clearance rate were higher than those of patients with HU ≥800(P＜0.05).The impact times of patients with calcium oxalate,mixed calcium and ammonium magnesium phosphate stones were higher than those with other components(P＜0.05),and the impact times of patients with calcium oxalate stones were the highest,and the crushing and clear-ance rate were lower than those of patients with other components(P＜0.05).Conclusion The CT value of upper urinary tract stones can predict the composition of stones to some extent.Patients with higher CT value and calcium oxalate stones have higher number of ES-WL impacts,lower stone crushing and clearance rate,and patients with higher CT value have more adverse reactions after treatment.
万方数据
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