西安交通大学学报（医学版）2024，Vol.45Issue(4)：535-541,7.DOI:10.7652/jdyxb202404002
影响能谱CTU虚拟平扫尿路结石检出的因素分析
Analysis of factors affecting the detection of urinary stone using virtual unenhanced images derived from dual-energy CTU
摘要
Abstract
Objective To evaluate the factors affecting urinary stone detection rate using virtual unenhanced(VUE)images obtained from triphasic dual-energy CT urography(DECTU)based on Logistic regression analysis.Methods For this study,150 patients who had suspected urinary stone and underwent triphasic DECTU were included.The true unenhanced(TUE)images were reconstructed as 120 kVp-like images,and VUE images at the portal venous phase[VUE(VP)]and excretory phase[VUE(EP)]were obtained using iodine removal technique from portal venous and excretory phase DECTU images,respectively.Two readers independently evaluated the above three types of images,and recorded the number of urinary stones,their anatomical locations,and whether there was residual iodine on the VUE images.Stone size and CT number were recorded only on the TUE images.Stone size,CT number,anatomical location,and iodine contrast agent were included in univariate and multivariate Logistic regression analyses to evaluate the factors affecting urinary stone detection rate using VUE images.Thresholds for detecting urinary stones on VUE images were determined using receiver operating characteristics(ROC)analysis.Results We detected 304 stones on TUE images,while the detection rates were 92.4％and 71.4％when using VUE(VP)and VUE(EP)images,respectively.Stone size and CT number were important factors influencing urinary stone detection rate using VUE(VP)and VUE(EP)images(P＜0.01).The area under curve(AUC)of using stone size and CT number for detecting stones using the VUE(VP)images was up to 0.96,and as threshold values,stones with size larger than 3.52 mm and CT number greater than 469 HU were found to have high accuracy.However,the AUC decreased to 0.88 when we combined stone size,CT number and anatomical location using the VUE(EP)images.In addition,different contrast agents did not affect the detection rate of stones on the VUE(EP)images(P=0.57).The stone detection rate in the kidney was significantly lower than those on the VUE(EP)images(P＜0.001).Conclusion VUE(VP)images provide better stone detection.Stone size and CT number have significant impacts on the stone detection rate using VUE images.The lower stone detection rate in the kidney on the VUE(EP)images is related to the residual iodine.关键词
能谱CT尿路造影(CTU)/尿路结石/虚拟平扫/检出/Logistic回归Key words
dual-energy spectral computed tomography urography(CTU)/urinary stone/virtual unenhanced(VUE)image/detection/Logistic regression分类
医药卫生引用本文复制引用
程燕南,李雅楠,孙精涛,田倩,杨建,同维,杨健,郭建新..影响能谱CTU虚拟平扫尿路结石检出的因素分析[J].西安交通大学学报（医学版）,2024,45(4):535-541,7.基金项目
陕西省高校联合项目一般项目(No.2020GXLH-Y-026) （No.2020GXLH-Y-026）
西安交通大学第一附属医院科研发展基金资助项目(No.2018MS-27,No.2021ZXY-04)Supported by the Key R&D Program of Shaanxi Province Universities and Colleges(No.2020GXLH-Y-026)and Institutional Founda-tion of The First Affiliated Hospital of Xi'an Jiaotong University(No.2018MS-27,No.2021ZXY-04) （No.2018MS-27,No.2021ZXY-04）
