In Vivo Multiple Parameters Quantitative Study Sub-differentiation Of Upper Urinary Calcium Calculi On Dual-source Dual-energy CT

Objective: To explore the clinical value of multiple parameters in differentiating various types of upper urinary calcium calculi in vivo,especially in detecting calcium-oxal ate-monohydrate(COM)stones.Methods: Totally 43 patients with 55 calcium calculi underwent dual-source CT in du-al-energy mode were analyzed.According to the result of infrared spectrometer,four types of calcium calculi were seen in the study: group1(COM,12),group2(COM+CO-D,calcium oxalate dihydrate,9),group3(COM+Ca P,carbonate apatite,8),group4(COM+COD+Ca P,26).Then combining the group2,group3 and group4,named mixed calc-ium calculi group.We used multiple parameters quantitative analysis sub-differentiation of calcium calculi.The one-Way ANOVA was used to compare the different of four groups.COM and mixed calcium calculi were compared by the independent sample t test.ROC curve for detecting COM was done to evaluate the diagnostic efficiency(v-s mixed calcium calculi group).A P value lower than 0.05 was considered statisticall-y significant.Results:(1)The parameters of DE ratios,DEI,curve slope,the different single spectral CT values and atomic number measured by four groups all had statistically significant,while the attenuation differences and electron density had no statistically significant.(2)DE ratios were significantly different between group 1,group 2 and group 4.DEI of group 4 with group 1,group 2,group 3 did differ significantly.Attenuation differe-nces can only distinguish between group3 and group 4.the single spectral CT values of 40~80 ke V showed similar changes,group 1 with group 2,group 3,group3 with group 4 were significantly different;the single spectral CT values of 90~100 ke V s howed similar changes,group 3 with group 1,group 4 were significantly different;the single-spectral CT values of 120 ke V~190 ke V also showed similar changes,group3 with other three groups were significantly different.the single spectral CT values of 110 ke V was the independent point of change,not only group 3 with other three groups were significantly different,but also can differentiation group 1 with group 2.The curve slope of group 1 with group 2 and group 3,group 2 with group 4,group3 with group 4 were significantly different.Atomic number of group 4 with group 1,group,group 3 did differ significantly.There were no significan-tly different in other groups.(3)The parameters of DE ratios,DEI,atomic number and curve slope canbe employed for di-fferentiation of COM and mixed calcium calculi,the DE ratios wa-s best.Conclusion: The multiple quantitative parameters obtained by dual-suorce dual-energy CT provied new ideal and new method,which can help to differentiation of various types of calcium calculi and for detection of relatively lithotripsy-resistant COM calcul-i,has important significance in the preoperative assessment.