双源CT尿路造影中双能量虚拟平扫检查尿路结石

目的 评价双源CT虚拟平扫(VNCT)在检查泌尿系统结石中的价值.方法 对2007年11月至2008年5月间于我院就诊的222例临床怀疑泌尿系统结石患者进行双源CT全腹部常规平扫(CNCT)及增强检查,并行肾脏排泄期双能量扫描(80 kV/400 mA和140 kV/95 mA).利用Liver VNC处理得到VNCT数据,与CNCT检出的阳性结石对照,比较CNCT和VNCT的辐射剂量.结果 222例患者中,有142例结石患者.CNCT检出结石183枚,其中肾实质内结石32枚,肾盂肾盏内结石56枚,腹段输尿管内结石40枚,盆段输尿管内结石22枚,膀胱壁段输尿管内18枚,膀胱内结石15枚;VNCT检出结石181枚,其中肾实质内结石30枚,肾盂肾盏内结石57枚,膀胱壁段输尿管内17枚,其余与普通平扫相同.CNCT与VNCT在检出阳性结石上有很高的一致性.VNCT较CNCT单次辐射剂量高(10.14±1.83)mGry vs (8.84±1.67)mGry;t=-25.98,P=0.001].结论 VNCT与CNCT在检出泌尿系统结石中具有很高一致性.尽管单次VNCT的辐射剂量高于CNCT,但因减少一次扫描,可降低辐射剂量.

Dual energy virtual nonenhanced CT detection of urinary stone in dual source CT urography

Objective To assess the value of virtual nonenhanced CT (VNCT) of dual source CT in the detection of urinary stones. Methods From Nov 2007 to May 2008, 222 patients suspected with urinary calculi underwent whole abdominal conventional nonenhanced CT (CNCT) and enhanced CT, and VNCT in the excretive phase (80 kV/400 mA and 140 kV/95 mA) was performed. VNCT data was postprocessed using the software of dual-energy (Liver VNC). The value of detection of urinary calculi was evaluated in comparison of CNCT. Radiation dose of both modalities was also compared. Results Among 222 patients, there were 183 stones in 142 patients in CNCT, including 32 stones in the renal parenchyma, 56 in renal pelvis, 40 in abdominal urinary, 22 in pelvis urinary, 18 in intramural bladder, 15 in bladder. In VNCT, 30 stones in the renal parenchyma, 57 in renal pelvis, 17 in intramural bladder, others being similar as CNCT. There was a high agreement for VNCT and CNCT to detect urinary stones. Conclusion There is a high agreement for VNCT and CNCT to detect urinary stones. VNCT can be used in clinical routine practice because of reduced radiation dose.