摘要目的 通过与非增强螺旋CT (UMDCT)检查对比,探讨普通静脉尿路造影(IVU)基础上的X线数字断层融合技术(DTS)在泌尿系统结石诊断中的应用价值.方法 对新疆维吾尔自治区人民医院2012年1月-2013年6月75例临床疑诊泌尿系统结石患者行IVU,在此基础上行DTS成像,所有患者同时进行了UMDCT检查.这3种影像模式诊断结果与手术进行对照,获得3种方法诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值.采用x2检验,观察3种成像方法之间的差异.结果 75例疑诊泌尿系统结石患者中60例手术证实为结石.IVU,IVU联合DTS,UMDCT诊断结石的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为70.0％、73.3％、70.7％、91.3％、37.9％;91.7％、86.7％、90.7％、96.5％、72.2％;96.7％、86.7％、94.7％、96.7％、86.7％. IVU联合DTS与UMDCT相比诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值上差异无统计学意义,两者诊断能力均高于IVU.结论 IVU基础上的DTS成像与UMDCT在泌尿系统结石的诊断能力上差异无统计学意义,可作为该疾病诊断的常规影像学技术.

abstractsObjective To evaluate the clinical application value of X-ray digital DTSynthesis (DTS) based on IVU (Intravenous Urography) in urinary calculi contrasted with unenhanced multidetector-row computerized tomography.Methods 75 patients suspected of urinary calculi underwent IVU,DTS based on IVU and UMDCT.The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive of the three imaging ways were acquired according to operations,respectively.Chi-square test was used to evaluate the difference among the three ways.Results In 75 cases,60 cases were proved to be urinary calculi.The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive of IVU,DTS based on IVU,UMDCT is 70.0％,73.3％,70.7％,91.3％,37.9％ ;91.7％,86.7％,90.7％,96.5％,72.2％ ; 96.7％,86.7％,94.7％,96.7％,86.7％,respectively.No significant differences between DTS based on IVU and UMDCT were found in sensitivity,specificity,accuracy,positive predictive value and negative predictive.Both cases are better than IVU in diagnostic ability.Conclusion There is no significant difference in diagnostic ability of urinary calculi between DTS and UMDCT.DTS can be used as a routine imaging technique in diagnosis and follow up of urinary calculi.