两种64层CT尿路成像方法对输尿管结石诊断价值的比较

目的比较两种64层CT尿路成像（CTU）方法对输尿管结石的诊断价值。方法本文包含两组资料。一组为阳性法组，收集B超提示输尿管结石，行静脉肾孟造影（IVP）的患者共36例，患者行IVP检查后接受64层CT平扫；另一组为阴性法组，收集23例急性肾绞痛疑为输尿管结石直接行64层CT平扫。将上述两组原始资料传送至工作站，用多平面重建，（MPR）及曲面重建（CPR）进行图像后处理，比较KUB＋IVP与CTU的诊断输尿管结石阳性率、阴性法CTU与超声的诊断输尿管结石阳性率以及阳性法CTU与阴性法CTU的诊断输尿管结石阳性率，用SPSS12．0软件进行χ^2检验。结果（1）阳性法组36例输尿管结石中，KUB＋IVP诊断正确者20例，阳性法CTU诊断正确者31例，两者差异有统计学意义（χ^2=8．13，P〈0．05）；（2）阴性法组23例输尿管结石中，阴性法CTU诊断正确者22例，B超诊断正确者15例，两者差异有统计学意义（χ^2=4．97，P〈0.05）；阳性法CTU与阴性法CTU诊断输尿管结石正确率无明显差异（χ^2=0．55，P〉0.05）。结论阴性法CTU与阳性法CTU对输尿管结石诊断率优于B超，KUB＋IVP；阴性法方便快捷、不需使用对比剂，尤其适用于肾绞痛患者的检查。

Comparison of diagnostic Values in ureteral stones with two methods of 64-slice CT urography

Objective To compare the diagnostic values of ureteral stones with two methods of 64-slice computed tomographic urography（CTU）. Methods Two groups were included： the positive group, 36 patients who were diagnosed ureteral stones by B ultrasound, underwent IVP and later or delayed CTU; the negative group, 23 patients with renal colic and suspection of ureteral stone, underwent emergency plain CT. The data of all the patients were transferred to workstation for 3D reconstruction of multiple plane reconstruction （MPR） and curve plane reformation （CPR）. χ^2 test was used with the statistic software of SPSS 12.0, to compare the diagnostic accuracy for ureteral stones between the methods of KUB＋IVP and CTU of positive, CTU of negative and B- Ultrasound, CTUs of positive and negative. Results （1）In positive group, 20 （20/36） cases of ureteral stone were confirmed by KUB＋IVP, 31 （31/36） by CTU. Between them, there was significant difference （χ^2 =8.13, p〈0,05）. （2）In negative group, 22（22/ 23） and 15（15/23） cases of ureteral stones were diagnosed by CTU and B ultrasound, respectively, with significant difference（ χ^2 =4.97, p〈0.05）. （3）There was no significant difference between CTUs of positive and negative for diagnostic accuracy of ureteral stones （χ^2 =0.55, p〉0.05）. Conclusion CTU of positive and negative were superior to B ultrasound and KUB＋WP for accuracy of diagnosing ureteral stones; CTU of negative, with advantages of convenience, non-contrast media, is especially suited for the checkup of patients with renal colic.