| Background:Kidney stones are a common type of disease in the urinary system,which can cause urinary tract obstruction,renal colic,acute pyelonephritis and other clinical manifestations.Severe cases may cause sepsis and end-stage renal disease.In the past few decades,the incidence and prevalence of kidney stones have been increasing in Western countries,and China is also one of the countries with high incidence of urinary calculi.After urinary calculi treatment,it is easy to relapse,and the composition of stones is closely related to the prevention and treatment of recurrence.Therefore,understanding the composition of the stone is of great significance for the diagnosis and treatment of stones,meanwhile the prevention of recurrence of stones.At present,the analysis of stone components is mainly in vitro analysis.The main way is to determine the composition of stones after surgical removal of them.There is no reliable way to accurately assess the composition of in situ stones.Dual-source computed tomography(DSCT)with dual-energy imaging technology has the ability to discriminate between stones with the same electron density but different photon absorption abilities by performing high-energy and low-energy scanning simultaneously in one scan.Therefore,while the stone is positioned by DSCT,an energy imaging can be obtained,making analysis of the stone composition possible.Purpose:The purpose of this study is to assess the value of DSCT with dual-energy imaging technology,which analyzing the composition of kidney stones.Methods:Ninety-six cases of vitro kidney stones were collected from inpatients.Firstly,these specimen were placed into fresh pig kidney which laying in a container with water.Vitro stones were scanned with dual-energy imaging technology.The CT value was measured at 80 kVp and 140 kVp.Secondly,calculating the CT value difference,the ratio of CT value,the double energy index(DEI)and the overlay value.Finally,infrared absorption spectrum(IAS)analyzed the composition of all the stones,evaluating the data of DSCT with dual-energy imaging technology.Statistical reslutes were compared with each other,by the Kruskal-Wallis H test and the Bonferroni pairwise comparison methods.Results:There were seventy-two calcium oxalatewas which was 75 percent in all stones,thirteen uricacid,eight hydroxy phosphorus,three mixed stones,but not cystine stone by infrared absorption spectrum.This study included only nienty-three stones excluding three mixed ones.There were significant differentiation in the CT value difference,the ratio of CT value,DEI and the overlay value among calcium oxalate,uricacid and hydroxy phosphorus stones(?~2=43.474,P<0.001;?~2=44.958,P<0.001;?~2=44.813,P<0.001;?~2=44.872,P<0.001).The differences among the three stones were statistically significant.Four index had good predictive function between calcium oxalate and uricacid stones.Area under curve(AUC)of them was each more than zero point nine five,meanwhile the sensitivity and specificity were both over 90 percent.The sensitivity of calcium oxalate,uricacid and hydroxy phosphorus stones was 97.2%,84.6%and 75%,the specificity was 90.5%,98.8%and 100%and the accuracy was95.7%,96.8%and 97.8%with dual-energy imaging technology.Conclusion:DSCT with dual-energy imaging technology has high accuracy in vitro kidney stones.It provides certain basis in analyzing the composition of situ kidney stones. |
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