Liu Shifeng, Wang Hong, Feng Weihua, Hu Xiaokun, Guo Jian, Shang Qingjun, Li Zixiang, Yu Hongsheng
Center for Interventional Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266555, P.R. China.
Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266555, P.R. China.
Exp Ther Med. 2018 Feb;15(2):1749-1753. doi: 10.3892/etm.2017.5531. Epub 2017 Nov 21.
Urinary calculus is a common and recurrent condition that affects kidney function. The present study evaluated the use of digital tomosynthesis (DTS) and Kidneys-Ureters-Bladder (KUB) radiography as methods of diagnosing urinary calculi. Unenhanced multidetector computed tomography (UMDCT) was used in the diagnosis of calculi. KUB radiography and DTS procedures were conducted on patients prior to and following bowel preparation to detect kidney, ureteral and bladder calculi. Differences in diagnostic performance of KUB radiography and DTS imaging on prepared and unprepared bowel were evaluated using the χ test. The consistency of diagnostic results between two examining physicians was analyzed using the κ test. A total of 138 calculi from 80 patients were detected via UMDCT. The calculi detection rates of KUB prior to and following bowel preparation were 47.8 and 66.7% respectively, and the calculi detection rate of DTS prior to and following bowel preparation were 94.2 and 96.4%, respectively. The detection rates of calculi >5 mm via KUB prior to and following bowel preparation were 56.6 and 73.5% respectively, and in DTS they were 100% prior to and following bowel preparation. Economically, DTS performed on the unprepared bowel was the most cost effective, followed by DTS on the prepared bowel, KUB on the unprepared bowel and KUB on the prepared bowel. Therefore, the current study concluded that DTS may be an appropriate first-line imaging technique in patients with urinary calculi.
尿路结石是一种常见且易复发的病症，会影响肾功能。本研究评估了数字断层合成（DTS）和腹部平片（KUB）作为诊断尿路结石方法的应用情况。采用非增强多层螺旋计算机断层扫描（UMDCT）诊断结石。在肠道准备前后对患者进行KUB平片和DTS检查，以检测肾、输尿管和膀胱结石。使用χ检验评估肠道准备前后KUB平片和DTS成像诊断性能的差异。采用κ检验分析两位检查医师诊断结果的一致性。通过UMDCT共检测出80例患者的138颗结石。肠道准备前后KUB平片的结石检出率分别为47.8%和66.7%，肠道准备前后DTS的结石检出率分别为94.2%和96.4%。肠道准备前后KUB平片对直径>5mm结石的检出率分别为56.6%和73.5%，DTS对直径>5mm结石的检出率在肠道准备前后均为100%。在经济方面，未进行肠道准备时行DTS检查最具成本效益，其次是进行肠道准备后行DTS检查、未进行肠道准备时行KUB平片检查以及进行肠道准备后行KUB平片检查。因此，本研究得出结论：DTS可能是尿路结石患者合适的一线成像技术。
