临床小儿外科杂志2024，Vol.23Issue(1)：40-45,6.DOI:10.3760/cma.j.cn101785-202304043-008
CT HU值判断小儿泌尿系结石成分的应用探讨
Application of computed tomography Hounsfield unit in the determination of urinary stone composition in children
摘要
Abstract
Objective To explore the application value of CT Hounsfield unit(HU)of urinary calculi in the determination of stone composition in children.Methods For this retrospective study,between April 2009 and April 2022,422 children of urinary tract calculi were recruited as research subjects.Based upon the results of postoperative stone composition analysis,they were assigned into 4 groups of calcium oxalate calculus,uric acid calculus,struvite and cystine calculus.Urinary pH value,HU value in stone core,HU value in stone periphery,average HU value and Hounsfield unit density(HUD)of stone were statistically examined.Results The HU value in the periphery of uric acid calculus group(399±158),calcium oxalate calculus group(529± 223),struvite group(556±312),cystine calculus group(566±154),uric acid calculus group was lower than calcium oxalate calculus group,struvite group and cystine calculus group,the differences were statistically sig-nificant(P＜0.05).The average HU value of uric acid calculus group(425±166),calcium oxalate calculus group(585±251),struvite group(597±326),cystine calculus group(589±155),uric acid calculus group was lower than calcium oxalate calculus group,struvite group and cystine calculus group,the differences were statistically significant(P＜0.05).The HU value in the core of the uric acid calculus group was(476±201),the calcium oxalate calculus group was(697±324),and the struvite group was(681±371).The HU value in the core of the uric acid calculus group was lower than that of the calcium oxalate calculus group and the stru-vite group,and the differences were statistically significant(P＜0.05).The HUD of the calcium oxalate calcu-lus group(65±27),uric acid calculus group(39±16),struvite group(54±25),cystine calculus group(41 ±17),calcium oxalate calculus group was higher than uric acid calculus group,struvite group and cystine cal-culus group,the differences were statistically significant(P＜0.05).The HUD of uric acid calculus group was lower than that of struvite group,and the difference was statistically significant(P＜0.05).The urine pH value of cystine calculus group was 6.5(6.0,7.13),calcium oxalate calculus group was 6.0(6.0,6.5),and uric acid calculus group was 6.0(6.0,6.5).The urine pH value of cystine calculus group was higher than that of calcium oxalate calculus group and uric acid calculus group,and the differences were statistically significant(P＜0.001).The area under curve(AUC)of HUD of calcium oxalate calculus and non-calcium oxalate calculus groups was 0.755 with a sensitivity of 0.722,a specificity of 0.705 and an optimal cut-off value of 48.Non-uric acid core calculus in uric acid calculus group had an AUC of 0.700 with a sensitivity of 0.607,a specificity of 0.764 and an optimal cutoff value of 566.AUC of median urinary pH value in cystine calculus and non-cystine calculus groups was 0.704 with a sensitivity of 0.682,a specificity of 0.657 and an optimal cutoff value of 6.25.Conclusions Measurement of CT HU value may provide references for determining the composition of calcium oxalate and uric acid calculi.When HU value of stone core is below 566,it hints at uric acid calculus.Calcium oxalate calculus is suggested when HUD is 48 or above.关键词
结石成分/判断/外科手术/儿童Key words
Stone Composition/Judgment/Surgical Procedures,Operative/Child引用本文复制引用
覃锋,邹志敏,何天衢,赵夭望,王智,李创业,易婷,孙小文,刘畅,李艳芳..CT HU值判断小儿泌尿系结石成分的应用探讨[J].临床小儿外科杂志,2024,23(1):40-45,6.基金项目
湖南省儿童泌尿生殖疾病临床医学研究中心(2021SK4017) （2021SK4017）
湖南省卫健委重点资助课题(202204054938)Hunan Provincial Clinical Medical Research Center for Pediatric Urogenital Diseases(2021SK4017) （202204054938）
Key Project of Health Commission of Hunan Province(202204054938) （202204054938）
