尿路结石：X线平片的准确性如何？

Urolithiasis: how accurate are plain radiographs?

作者信息

Chan V O, Buckley O, Persaud T, Torreggiani W C

机构信息

Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin, Ireland.

出版信息

Can Assoc Radiol J. 2008 Jun;59(3):131-4.

PMID:18697719

Abstract

OBJECTIVE

To determine the value of the kidneys, ureters, and bladder radiograph (KUB) in the diagnosis of urolithiasis using unenhanced helical computerized tomography (UHCT) as the gold standard.

METHODS

A retrospective study was performed on 100 consecutive patients being investigated for suspected urolithiasis. All patients presented with acute renal colic and had a KUB and UHCT within a 3-hour period. UHCT and KUB pairs were assessed separately by 2 radiologists in consensus who were blinded to the clinical details of the patients and the results of the other tests and examinations. The presence, location, number, and size of stones were recorded. Each UHCT and KUB pair was then compared for concordance on a stone-by-stone basis.

RESULTS

KUB was concordant with the gold standard UHCT in only 50% of patients (11 positive, 39 negative), giving a sensitivity of 18.6%, a specificity of 95.1%, a positive predictive value of 84.6%, and a negative predictive value of 44.8%.

CONCLUSION

KUB has a very low sensitivity for the detection of urolithiasis, although specificity is acceptable.

摘要

目的

以非增强螺旋计算机断层扫描（UHCT）作为金标准，确定肾脏、输尿管和膀胱X线平片（KUB）在尿路结石诊断中的价值。

方法

对100例连续接受疑似尿路结石检查的患者进行回顾性研究。所有患者均表现为急性肾绞痛，并在3小时内进行了KUB和UHCT检查。由2名放射科医生分别对UHCT和KUB图像进行评估，他们在不了解患者临床细节和其他检查结果的情况下达成共识。记录结石的存在、位置、数量和大小。然后逐块比较每对UHCT和KUB图像的一致性。