首页|影响能谱CTU虚拟平扫尿路结石检出的因素分析

影响能谱CTU虚拟平扫尿路结石检出的因素分析

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原文链接
  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
目的 基于Logistic回归分析评估影响能谱CT尿路造影(CTU)虚拟平扫图像检出尿路结石的因素.方法 回顾性纳入150例尿路结石并行能谱CTU的患者(记录所用碘对比剂).将平扫图像重建为120 kVp-like图像,静脉期和排泄期的增强图像采用碘去除技术分别重建为静脉期和排泄期的虚拟平扫图像.2位医师独立评估以上3组图像,并记录3组图像的尿路结石数量、所在解剖位置及虚拟平扫图像是否有碘残留;结石大小和CT值仅在真实平扫图像上测量.结石大小、CT值、结石所在位置和所用碘对比剂纳入Logistic回归分析,用于评估影响虚拟平扫尿路结石检出的因素.受试者工作特征(ROC)曲线用于绘制各指标的曲线下面积(AUC)值、诊断灵敏度和特异度及最佳临界值.结果 真实平扫上检出304枚结石,而静脉期和排泄期虚拟平扫结石检出率分别为92.4％和71.4％.结石大小和CT值是影响静脉期和排泄期虚拟平扫结石检出的独立风险因素(P＜0.01),结石大小和CT值在静脉期虚拟平扫结石检出的AUC值达0.96以上,诊断临界值分别是3.52 mm和469 HU,而在排泄期虚拟平扫结石检出的结石大小、CT值及解剖位置等指标的综合AUC值降为0.88.排泄期虚拟平扫结石检出率在碘对比剂组间无统计学差异(P=0.57).另外,排泄期肾盂肾盏处虚拟平扫结石检出率明显降低(P＜0.001).结论 在增强CT的2个扫描期相中,静脉期虚拟平扫结石检出效果更佳.结石大小和CT值是影响虚拟平扫结石检出的重要因素.肾盂肾盏处排泄期虚拟平扫结石检出率低与碘去除效果欠佳相关.
Analysis of factors affecting the detection of urinary stone using virtual unenhanced images derived from dual-energy CTU
Objective To evaluate the factors affecting urinary stone detection rate using virtual unenhanced(VUE)images obtained from triphasic dual-energy CT urography(DECTU)based on Logistic regression analysis.Methods For this study,150 patients who had suspected urinary stone and underwent triphasic DECTU were included.The true unenhanced(TUE)images were reconstructed as 120 kVp-like images,and VUE images at the portal venous phase[VUE(VP)]and excretory phase[VUE(EP)]were obtained using iodine removal technique from portal venous and excretory phase DECTU images,respectively.Two readers independently evaluated the above three types of images,and recorded the number of urinary stones,their anatomical locations,and whether there was residual iodine on the VUE images.Stone size and CT number were recorded only on the TUE images.Stone size,CT number,anatomical location,and iodine contrast agent were included in univariate and multivariate Logistic regression analyses to evaluate the factors affecting urinary stone detection rate using VUE images.Thresholds for detecting urinary stones on VUE images were determined using receiver operating characteristics(ROC)analysis.Results We detected 304 stones on TUE images,while the detection rates were 92.4％and 71.4％when using VUE(VP)and VUE(EP)images,respectively.Stone size and CT number were important factors influencing urinary stone detection rate using VUE(VP)and VUE(EP)images(P＜0.01).The area under curve(AUC)of using stone size and CT number for detecting stones using the VUE(VP)images was up to 0.96,and as threshold values,stones with size larger than 3.52 mm and CT number greater than 469 HU were found to have high accuracy.However,the AUC decreased to 0.88 when we combined stone size,CT number and anatomical location using the VUE(EP)images.In addition,different contrast agents did not affect the detection rate of stones on the VUE(EP)images(P=0.57).The stone detection rate in the kidney was significantly lower than those on the VUE(EP)images(P＜0.001).Conclusion VUE(VP)images provide better stone detection.Stone size and CT number have significant impacts on the stone detection rate using VUE images.The lower stone detection rate in the kidney on the VUE(EP)images is related to the residual iodine.

dual-energy spectral computed tomography urography(CTU)urinary stonevirtual unenhanced(VUE)imagedetectionLogistic regression

程燕南、李雅楠、孙精涛、田倩、杨建、同维、杨健、郭建新

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西安交通大学第一附属医院医学影像科,陕西西安 710061

西安交通大学第一附属医院临床研究中心,陕西西安 710061

能谱CT尿路造影(CTU) 尿路结石 虚拟平扫 检出 Logistic回归

陕西省高校联合项目一般项目西安交通大学第一附属医院科研发展基金资助项目西安交通大学第一附属医院科研发展基金资助项目

2020GXLH-Y-0262018MS-272021ZXY-04

2024

10.7652/jdyxb202404002

西安交通大学学报(医学版)
西安交通大学

西安交通大学学报(医学版)

CSTPCD北大核心
影响因子：1.144
ISSN：1671-8259
年,卷(期)：2024.45(4)