Meister B, Rassweiler M C, Weiß C, Häcker A, Ritter M
Department of Urology, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany,
World J Urol. 2015 Jul;33(7):1039-43. doi: 10.1007/s00345-014-1385-3. Epub 2014 Aug 28.
Residual calculi after stone therapy need to be treated if they are clinically significant, mainly depending on the size of the calculi. There are different ways to detect and measure the size of residual calculi as for example KUB or computed tomography. The Uro Dyna-CT (Siemens Healthcare solutions, Erlangen, Germany) allows cross-sectional imaging and 3D reconstructions during endourological interventions. In this ex vivo study, we investigate the accuracy of imaging residual calculi with the Uro Dyna-CT.
Twenty-seven artificial stones (plaster of Paris) were scanned with the Uro Dyna-CT by a special urolithiasis protocol and post-image processing with 3D-reconstruction and cross-sectional imaging was performed. The major diameter of each stone was measured at the dedicated workstation by one investigator. The same stones were measured randomized with a digital caliper (real size). Finally, the two measurements were compared. The paired t test, Pearson's correlation coefficient, the F Test, a reference area for differences, the intraclass correlation coefficient, the Maloney-Rastogi test and the Bland-Altman analysis were used for statistical analyses.
The range of stone sizes was 3-5 mm. We did not find significant differences in the size of the stones measured with the Uro Dyna-CT and the digital caliper (paired t test p = 0.3597) and we showed a good correlation between the two measuring methods (intraclass correlation coefficient 0.4465; p = 0.0088).
Renal calculi can be measured highly accurately with the Uro Dyna-CT. Whether this technique will lead to less residual fragments after stone treatment needs to be shown in further studies.
结石治疗后的残余结石若具有临床意义则需要进行治疗,这主要取决于结石的大小。检测和测量残余结石大小有不同的方法,例如腹部平片(KUB)或计算机断层扫描。泌尿动态CT(德国埃尔兰根西门子医疗解决方案公司)可在内腔泌尿外科干预过程中进行断层成像和三维重建。在这项体外研究中,我们探讨了使用泌尿动态CT对残余结石进行成像的准确性。
按照特殊的尿路结石方案,使用泌尿动态CT对27颗人工结石(巴黎石膏)进行扫描,并进行三维重建和断层成像的图像后处理。由一名研究人员在专用工作站测量每颗结石的最大直径。用数字卡尺(实际尺寸)对相同的结石进行随机测量。最后,比较这两种测量结果。采用配对t检验、Pearson相关系数、F检验、差异参考区间、组内相关系数、Maloney-Rastogi检验和Bland-Altman分析进行统计分析。
结石大小范围为3 - 5毫米。我们发现,使用泌尿动态CT测量的结石大小与用数字卡尺测量的结果无显著差异(配对t检验p = 0.3597),且两种测量方法之间具有良好的相关性(组内相关系数0.4465;p = 0.0088)。
使用泌尿动态CT能够高度准确地测量肾结石。这种技术在结石治疗后是否会减少残余碎片,有待进一步研究证实。