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双能计算机断层扫描在尿路结石诊断与治疗中的临床意义

[Clinical implications of dual-energy computed tomography in the diagnosis and treatment of urolithiasis].

作者信息

Kapanadze L B, Ternovoy S K, Rudenko V I, Serova N S

机构信息

Department of Diagnostic Imaging and Radiation Therapy, Faculty of Medicine, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia.

Department of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia.

出版信息

Urologiia. 2018 Mar(1):143-149.

Abstract

Urolithiasis (urolithiasis) is one of the most common urologic diseases with an estimated prevalence of no less than 3% in the population, usually affecting active working-age patients of 30-50 years. Taking into account major public health and economic significance of this problem, there is the need for the development of effective modern diagnostic techniques. Rapid medical-technological advances of the past two decades have led to the wide spread use of minimally invasive surgery the management of urolithiasis. Nevertheless, surgical intervention only removes the result of a long pathological process and does not change its course. Thus, there is a need for a detailed understanding of the etiology, epidemiology, and pathogenesis of urolithiasis. Diagnostic imaging plays a key role in the diagnosis of urolithiasis. Multislice spiral computed tomography (MSCT) is the gold standard for the diagnosis of urolithiasis. It provides information about the size, location, and density of the calculus. Over the past decade, the use of dual-energy computed tomography (DECT) in urological practice has been widely discussed in the international and domestic literature. One of the main advantages of DECT is the ability to determine the chemical composition of urinary stones. Previous studies have reported a high diagnostic value of the method, including the ability to predict treatment outcomes. However, the shortcomings of the method and the absence of standardized examination protocols leave a wide field for further research. This article reviews major distinctive features of using DECT in the diagnosis of urolithiasis.

摘要

尿路结石是最常见的泌尿系统疾病之一,据估计其在人群中的患病率不少于3%,通常影响30至50岁的在职适龄患者。考虑到该问题对公共卫生和经济的重大意义,有必要开发有效的现代诊断技术。过去二十年医学技术的快速进步导致微创手术在尿路结石治疗中的广泛应用。然而,手术干预仅消除了长期病理过程的结果,并未改变其进程。因此,有必要详细了解尿路结石的病因、流行病学和发病机制。诊断成像在尿路结石的诊断中起着关键作用。多层螺旋计算机断层扫描(MSCT)是尿路结石诊断的金标准。它提供有关结石大小、位置和密度的信息。在过去十年中,双能计算机断层扫描(DECT)在泌尿外科实践中的应用在国际和国内文献中得到了广泛讨论。DECT的主要优点之一是能够确定尿结石的化学成分。先前的研究报道了该方法的高诊断价值,包括预测治疗结果的能力。然而,该方法的缺点以及缺乏标准化的检查方案为进一步研究留下了广阔空间。本文综述了使用DECT诊断尿路结石的主要显著特征。

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