摘要
目的 研究低剂量计算机断层扫描(computed tomography,CT)联合图像域迭代重建算法(image domain iterative reconstruction algorithm,IRIS)对泌尿系结石的诊断价值,并对结石的成分进行分析。方法 选择北京市大兴区人民医院2020年1月至2021年1月泌尿外科泌尿系结石患者206例作为研究对象,所有患者均行手术治疗,术前均经常规剂量和低剂量CT检查,以手术结果为金标准。常规剂量CT图像采用滤波反投影算法(filtered back projection algorithm,FBP)重建;低剂量CT图像分别采用FBP和IRIS,将原始数据传入GE AW4.6工作站,选取结石最大层面根据CT原子序数法判定结石成分。比较两种剂量CT对泌尿系结石的检出率、敏感度、特异度、辐射剂量;比较低剂量CT图像FBP和IRIS重建平均噪声标准偏差(SD)、平均信噪比及CT判定结石成分的符合率。结果 常规CT检出肾结石、输尿管结石的符合率均为100.00%,低剂量CT分别为97.58%、98.78%,差异无统计学意义(P>0.05)。低剂量CT辐射剂量为(2.96±0.21)m Gy,明显低于常规剂量CT的(18.63±2.75)m Gy,差异有统计学意义(P<0.05)。低剂量CT联合IRIS平均噪声SD为(14.42±1.37),低于联合FBP的(20.31±2.49);低剂量CT联合IRIS平均信噪比为(2.07±0.53),高于联合FBP的(1.31±0.28),差异有统计学意义(P<0.05)。206例患者结石取出后经红外光谱分析结石成分分别为草酸钙结石、尿酸结石、磷酸铵镁结石、胱氨酸结石;CT原子序数法分析草酸钙结石符合率97.83%(90/92),尿酸结石94.94%(75/79),磷酸铵镁结石90.91%(10/11),胱氨酸结石87.50%(21/24)。CT原子序数法结石成分分析与红外光谱分析草酸钙结石、尿酸结石、磷酸铵镁结石、胱氨酸结石的Kappa值分别为0.517、0.473、0.562、0.459。结论低剂量CT联合IRIS可在降低辐射的前提下获得高质量的图像,使泌尿系结石的检出率基本达到常规剂量CT的水平,对结石成分的判定符合率较高,是泌尿系
Objective To study the diagnostic value of low-dose computer tomography(CT)combined with image domain iterative reconstruction algorithm(IRIS)for urinary calculi,and to analyze the components of the calculi.Method A total of 206 patients with urinary calculi in our hospital’s urology department from danuary 2020 to danuary 2021 were selected as the research subjects.All patients underwent surgical treatment and conventional and low-dose CT examinations before surgery.The surgical results were used as the gold standard.Conventional dose CT images were reconstructed by filtered back projection algorithm(FBP);low dose CT images were reconstructed by FBP and image domain iterative reconstruction algorithm(IRIS)respectively,and the raw data were transferred to GE AW4.6 workstation to determine stone composition.The detection rate,sensitivity,specificity and radiation dose of two doses of CT for urinary calculi were compared;the average noise standard deviation(SD),average signal-to-noise ratio of FBP and IRIS reconstruction of lowdose CT images,and the coincidence rate of CT to determine calculus composition were compared.Result The coincidence rates of conventional CT in detecting kidney stones and ureteral stones were both 100.00%,while those of low-dose CT were 97.58% and 98.78%,respectively,with no significant difference(P>0.05).The radiation dose of low-dose CT was(2.96±0.21)m Gy,which was significantly lower than(18.63±2.75)m Gy of conventional dose CT,and the difference was statistically significant(P<0.05).The average noise of low-dose CT combined with IRIS was(14.42±1.37),which was lower than that of combined FBP(20.31±2.49);the average signal-to-noise ratio of low-dose CT combined with IRIS was(2.07±0.53),which was higher than that of combined FBP(1.31±0.28),and the difference was statistically significant(P<0.05).After the stones were removed from 206 patients,the stone components were analyzed by infrared spectroscopy:calcium oxalate stones,uric acid stones,ammonium magnesium phosphate stones,and c
作者
于宝玉
张斌
张博洋
傅顺斌
Yu Baoyu;Zhang Bing;Zhang Boyang;Fu Shunbing(Statistics Office,Beijing Daxing District People's Hospital,Beijing 102600,China;Department of Radiology,Beijing Daxing District Peoples Hospital,Beijing 102600,China)
出处
《中国医学前沿杂志（电子版）》
2022年第10期31-35,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
大兴区科技计划项目(4202006314)。
关键词
低剂量CT
图像域迭代重建算法
泌尿系结石
结石成分
Low-dose CT
Image domain iterative reconstruction algorithm
Urinary calculi
Stone composition
