| Objective: To measure the CT value of simple infectious calculi and non-infectious calculi before operation,to explore the threshold of CT value in infectious calculi and the clinical application value and early warning significance of CT value in infectious calculi,To provide some reference for clinical diagnosis of infectious calculi and to provide some experience and guidance for reducing sepsis during and after operation.Methods: The clinical data of 476 patients with kidney calculi were collected retrospectively from April 2012 to October 2018 in the affiliated hospital of Zunyi Medical University.Review the CT images of all patients,use CT-related software to measure the CT values of simple infectious calculi,mixed infectious calculi and other non-infectious calculi centers and periphery from CT images,the difference between the CT values of infectious calculi and non-infectious calculi was compared.The CT values of the center and periphery of simple infectious calculi and mixed infectious calculi were measured respectively,and the differences between the CT values of the center and periphery of infectious calculi were compared.Urine routine and p H values were collected for comparative analysis.Draw ROC curve,the area under the ROC curve was calculated to determine the cut-off value for the diagnosis of simple infectious calculus.Results: The 476 patients with kidney calculi,180 cases of infectious kidney calculi,22 cases of simple infectious kidney calculi with CT value(78±128)HU,158 cases of mixed infectious kidney calculi include: 80 cases of calcium oxalate monohydrate + calcium oxalate dihydrate + apatite carbonate calculi with CT value(1217±198)HU,50 cases of calcium oxalate monohydrate + apatite carbonate+magnesium phosphate hexahydrate calculi with CT value(1157 ± 188)HU,15 cases of calcium oxalate monohydrate +calcium oxalate dihydrate + apatite carbonate + magnesium phosphate hexahydrate calculi with CT value(1237 ± 104)HU,13 cases of ammonium urate + calcium oxalate monohydrate stones with CT value(1154 ± 124)HU.127 cases of other types of simple calcium oxalate monohydrate with CT value(1272±151)HU,16 cases of anhydrous uric acid calculi with CT value(593±109)HU,2 cases of cystine calculi with CT value(855)HU,2 cases of calcium dihydrogen phosphate dihydrate with CT value(1020)HU.149 cases of other types of mixed kidney calculi include: 93 cases of calcium oxalate monohydrate + calcium oxalate dihydrate with CT value(1263 ± 158)HU,51 cases of anhydrous uric acid + calcium oxalate monohydrate with CT value(1031 ± 200)HU,5cases of calcium hydrogen phosphate dihydrate + calcium oxalate monohydrate with CT value(1083 ± 63)HU.Due to the small amount of cystine calculi and calcium hydrogen phosphate dihydrate calculi,they were not included in the statistical analysis.The results of the study showed that there was a statistically significant difference between the CT values of simple infectious calculi and calcium oxalate monohydrate calculi and anhydrous uric acid calculi(P<0.05).The CT value of mixed calculi is between the CT value of the corresponding simple stones,but the CT value of mixed stones formed by different types of calculi is different.There was a statistically significant difference between the CT values of the simple infectious calculi group and the mixed infectious calculi group(P<0.001),and there was no statistical difference between the mixed infectious calculi group(P>0.05).The CT value of the center of infectious calculi was significantly greater than the CT value of the periphery of the stones(P<0.05),and the difference of mixed infectious calculi group was obvious.The urine p H of simple infectious calculi was significantly higher than that of simple calcium oxalate calculi and urate calculi(P<0.05),The area under the simple infectious calculus ROC curve of infectious calculus was 0.937(95%CI: 0.915~0.959),The cut-off value of infectious calculi was 951 HU.Conclusions:1.The composition of stones can be preliminarily judged by measuring the CT value of calculi,which has certain clinical guiding significance.2.The CT value 951 HU is an early warning value for infectious calculi.Combined with urine p H was alkaline and calculi composition analysis,urate calculi and cystine calculi were excluded,the CT value is less than this average value and the tendency of infectious calculi is considered,which has early warning significance.which is beneficial to the prevention and treatment of urinary sepsis during and after surgery. |
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