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双能计算机断层扫描中尿结石成分分析

analysis of urinary stone composition in dual-energy computed tomography.

作者信息

Stępień Monika, Chrzan Robert, Gawlas Wojciech

机构信息

Department of Radiology, Jagiellonian University in Kraków, Collegium Medicum, Poland.

Department and Clinic of Urology, Jagiellonian University in Kraków, Collegium Medicum, Poland.

出版信息

Pol J Radiol. 2018 Sep 10;83:e421-e425. doi: 10.5114/pjr.2018.79588. eCollection 2018.

DOI:10.5114/pjr.2018.79588
PMID:30655920
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6334123/
Abstract

PURPOSE

Dual energy computed tomography (DECT) is a new method of computed tomography (CT) imaging, allowing the assessment of not only the object's morphology, but also its composition. The aim of the study was to evaluate the potential of in vitro DECT evaluation of urinary stones' chemical composition.

MATERIAL AND METHODS

Six samples of surgically removed renal stones were scanned using DECT and analyzed by scanner vendor software. Uric acid stones were marked red and calcium stones white by the software. The real composition of the stones was finally verified using physicochemical laboratory analysis.

RESULTS

In 5 out of 6 samples, the composition of stones in DECT (3 samples identified as uric acid and 2 samples as calcium) was consistent with the physicochemical analysis (3 samples identified as uric acid, 1 as calcium phosphate, 1 as calcium oxalate). In DECT it was not possible to determine more precisely the type of calcium compounds (calcium phosphate vs. calcium oxalate) as established in the physicochemical analysis.In one stone identified in physicochemical analysis as uric acid, DECT detected a composite layered structure containing both uric acid and calcium compounds.

CONCLUSIONS

DECT allows uric acid to be distinguished from calcium urinary tract stones, which is crucial in the choice of appropriate therapy. Using the available hardware and software, it was not possible to more accurately distinguish types of calcified stones. Evaluation of the stone type in DECT may be limited in the case of mixed chemical composition.

摘要

目的

双能计算机断层扫描（DECT）是计算机断层扫描（CT）成像的一种新方法，不仅可以评估物体的形态，还可以评估其成分。本研究的目的是评估体外DECT评估尿路结石化学成分的潜力。

材料与方法

使用DECT对6个手术切除的肾结石样本进行扫描，并通过扫描仪供应商软件进行分析。软件将尿酸结石标记为红色，钙结石标记为白色。最后通过物理化学实验室分析验证结石的实际成分。

结果

6个样本中有5个样本，DECT检测到的结石成分（3个样本鉴定为尿酸结石，2个样本鉴定为钙结石）与物理化学分析结果一致（3个样本鉴定为尿酸结石，1个样本鉴定为磷酸钙结石，1个样本鉴定为草酸钙结石）。在DECT中，无法像物理化学分析那样更精确地确定钙化合物的类型（磷酸钙与草酸钙）。在物理化学分析中鉴定为尿酸结石的一块结石中，DECT检测到一种包含尿酸和钙化合物的复合分层结构。

结论

DECT可以区分尿酸结石和含钙尿路结石，这对选择合适的治疗方法至关重要。使用现有的硬件和软件，无法更准确地区分钙化结石的类型。对于化学成分混合的结石，DECT对结石类型的评估可能会受到限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/84dd2f871b82/PJR-83-79588-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/76d1d495a62e/PJR-83-79588-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/3b719c93ca6e/PJR-83-79588-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/434e1d36e20f/PJR-83-79588-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/1f6a73934c2e/PJR-83-79588-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/1d8c88c0a5b1/PJR-83-79588-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/6fe415d5cc91/PJR-83-79588-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/3100b8ab052c/PJR-83-79588-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/84dd2f871b82/PJR-83-79588-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/76d1d495a62e/PJR-83-79588-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/3b719c93ca6e/PJR-83-79588-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/434e1d36e20f/PJR-83-79588-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/1f6a73934c2e/PJR-83-79588-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/1d8c88c0a5b1/PJR-83-79588-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/6fe415d5cc91/PJR-83-79588-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/3100b8ab052c/PJR-83-79588-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8941/6334123/84dd2f871b82/PJR-83-79588-g008.jpg

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Determining the composition of urinary tract calculi using stone-targeted dual-energy CT: evaluation of a low-dose scanning protocol in a clinical environment.使用结石靶向双能CT确定尿路结石的成分：临床环境中低剂量扫描方案的评估
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