摘要
目的分析胰管结石的CT值与体外冲击波碎石治疗效果的关系。方法回顾性分析2016年7月至2022年8月于浙江大学医学院附属杭州市第一人民医院消化内科接受体外冲击波碎石术治疗的156例胰管结石患者的临床资料。依据碎石后结石残留的大小分为完全碎石组(n=97)与不完全碎石组(n=59),比较两组患者结石的CT最大值、最小值、平均值及最大横截面的周长。通过ROC曲线确定各指标的最佳截止值,计算曲线下面积(AUC),采用Delong检验比较AUC差异。结果完全碎石组治疗前结石周长[(4.23±1.87)cm vs(6.21±2.51)cm,P<0.001],CT最大值[(1173.79±423.37)Hu vs(1511.81±447.60)Hu,P<0.001]、最小值[(560.97±275.41)Hu vs(831.59±374.64)Hu,P<0.001]、平均值[(900.19±356.22)Hu vs(1153.93±371.29)Hu,P<0.001]均小于不完全碎石组,完全碎石组ESWL治疗次数及首次ESWL冲击次数均少于不完全碎石组。ROC曲线分析最佳截断值,结石周长为4.675 cm,CT最大值为1137 Hu、最小值为700.5 Hu、平均值为857 Hu,其中结石周长的诊断效能最好(AUC=0.746),CT最大值、平均值具有较好的敏感性(81.4%),而CT最小值具有较好的特异性(73.2%)。Delong检验显示CT最大值、最小值、平均值及周长的AUC差异无统计学差异。结论当胰管结石周长小于4.675 cm、CT最大值小于1137 Hu、最小值小于700.5 Hu、平均值小于857 Hu时,体外冲击波碎石治疗更容易碎石成功。
Objective To evaluate the correlation between CT value of pancreatic duct stones and the therapeutic efficacy of extracorporeal shock wave lithotripsy(ESWL).Methods The clinical data of 156 patients with pancreatic duct stones,who underwent extracorporeal shock wave lithotripsy in the Affilliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,from Jul.2016 to Aug.2022,were retrospectively analyzed.According to the size of residual stones after lithotripsy,the patients were divided into complete lithotripsy group(n=97)and incomplete lithotripsy group(n=59).The maximum CT value,minimum value,mean value,and size of the maximum cross section of the stones were compared between the two groups.Optimal cut-off value for each measure was determined by the ROC curve.Areas under the curve(AUC)of these indicators were calculated,and compared by Delong test.Results Perimeter of stone size[(4.23±1.87)cm vs(6.21±2.51)cm,P<0.001],maximum CT value[(1173.79±423.37)Hu vs(1511.81±447.60)Hu,P<0.001],minimum CT value[(560.97±275.41)Hu vs(831.59±374.64)Hu,P<0.001],and mean CT value[(900.19±356.22)Hu vs(1153.93±371.29)Hu,P<0.001]before treatment in the complete lithotripsy group were lower than those in incomplete lithotripsy group,and the number of ESWL treatments and the number of first ESWL impacts in the complete lithotripsy group were less than those in the incomplete lithotripsy group.ROC curve analysis showed that the optimal cut-off value was 4.675 cm,the maximum CT value was 1137 Hu,the minimum CT value was 700.5 Hu,and the mean value was 857 Hu,of which the stone size had the best diagnostic efficacy(AUC=0.746),the maximum CT value and the mean value had good sensitivity(81.4%),while the minimum CT value had good specificity(73.2%).Delong test showed no significant difference in AUC for maximum,minimum and mean size of stone in the CT scan.Conclusion Treating pancreatic duct stones<4.675 cm,the maximum CT value<1137 Hu,the minimum value<700.5 Hu,and the average value<857 Hu with ESWL may tur
作者
武春英
顾伟刚
焦小飞
丁忠祥
WU Chunying;GU Weigang;JIAO Xiaofei;DING Zhongxiang(Department of Radiology,Affilliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China;Department of Gastroenterology,Affilliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China)
出处
《肝胆胰外科杂志》
CAS
2023年第6期361-365,共5页
Journal of Hepatopancreatobiliary Surgery
基金
浙江省医药卫生科技计划项目(2019RC237)
杭州市医药卫生科技项目(A20200828)。
关键词
胰管结石
体外冲击波碎石
计算机断层扫描值
结石周长
pancreatic duct stones
extracorporeal shock wave lithotripsy
computed tomography value
perimenter of stone
