摘要目的:探讨压腹增强CT诊断飞行员肾脏微小结石的准确性。方法:回顾性分析162例可疑肾结石民航飞行员的平扫及压腹增强CT，记录可疑结石大小、位置、与肾盂肾盏内对比剂的关系；在超声引导下行输尿管电子纤维软镜检查及取石，记录结石、肾盏憩室内结石及钙化情况。结果:162例飞行员中压腹增强CT共检出拟诊肾结石297枚、憩室内结石4枚、肾乳头钙化61枚；输尿管电子纤维软镜明确肾结石245枚、憩室内结石4枚、肾乳头钙化101枚。以输尿管电子纤维软镜结果为金标准，压腹增强CT的准确率、敏感性、特异性、阳性预测值及阴性预测值分别为82.32%、95.40%、48.51%、82.72%和80.33%。结论:压腹增强CT基本能够明确区分肾结石、憩室内结石及肾乳头钙化。这种无创的肾结石诊断方法可用于飞行员体检鉴定。

abstractsObjective:To investigate the accuracy of abdominal compression enhanced CT in the diagnosis of pilots with renal microlithiasis.Methods:The plain scan and abdominal compression enhanced CT diagnoses of 162 civil pilots with suspected renal calculi were retrospectively analyzed. The size and location of suspected calculi and the relationship with renal pelvis and calyces contrast agent were recorded. Under the guidance of ultrasound, electron fiberoptic ureteroscopy and lithotomy were performed, and the calculi, calyces diverticulum calculi and calcification were recorded.Results:In 162 pilots, 297 suspected kidney calculi, 4 diverticulum calculi and 61 papillary calcifications were detected by abdominal compression enhanced CT. Two hundred and forty-five kidney calculi, 4 diverticulum calculi and 101 papillary calcifications were detected by electron fiberoptic ureteroscopy. When taking the results of electron fiberoptic ureteroscopy as the gold standard, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of abdominal compression enhanced CT was 82.32%, 95.40%, 48.51%, 82.72% and 80.33%, respectively.Conclusion:The abdominal compression enhanced CT can distinguish kidney calculi, diverticulum calculi and renal papillary calcification. The noninvasive diagnosis of kidney calculi can be applied in the physical examination and qualification assessment of pilots.