Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Sci Rep. 2020 Feb 5;10(1):1927. doi: 10.1038/s41598-020-58805-x.
In this study, the term "ultrasonic ureteral crossing sign" is defined, and the diagnostic accuracy of this sign in the rapid localization of ureteral calculi is assessed. Between January 2017 and June 2018, 535 patients underwent ultrasound examination for suspected ureteral calculi. The "ultrasonic ureteral crossing sign" was classified as either positive or negative and correlated with the location of ureteral calculi. Of the 451 patients who were ultimately diagnosed with ureteral calculi, 263 patients had a positive sign, of which 258 patients had distal ureteral calculi, and 188 patients had a negative sign, of which 164 patients had proximal ureteral calculi. Eighteen stones were located in the ureter across the iliac vessels. For patients with a positive "ultrasonic ureteral crossing sign", we observed a 91% sensitivity, 97% specificity, 98% PPV, 87% NPV, and AUC of 0.94 for distal ureteral calculi. For patients with a negative "ultrasonic ureteral crossing sign", we observed a 97% sensitivity, 91% specificity, 87% PPV, 98% NPV, and AUC of 0.94 for proximal ureteral calculi. The "ultrasonic ureteral crossing sign" was found to accurately predict the location of ureteral calculi, significantly improve the efficiency of ultrasound examination, and provide a useful basis for follow-up treatment.
在本研究中，定义了“超声输尿管跨越征”一词，并评估了该征象在快速定位输尿管结石中的诊断准确性。2017 年 1 月至 2018 年 6 月期间，535 例疑似输尿管结石患者接受了超声检查。将“超声输尿管跨越征”分为阳性或阴性，并与输尿管结石的位置相关联。在最终诊断为输尿管结石的 451 例患者中，263 例患者有阳性征象，其中 258 例为输尿管下段结石，188 例患者为阴性征象，其中 164 例为输尿管上段结石。18 颗结石位于髂血管处的输尿管内。对于“超声输尿管跨越征”阳性的患者，我们观察到其对输尿管下段结石的灵敏度为 91%、特异性为 97%、PPV 为 98%、NPV 为 87%，AUC 为 0.94。对于“超声输尿管跨越征”阴性的患者，我们观察到其对输尿管上段结石的灵敏度为 97%、特异性为 91%、PPV 为 87%、NPV 为 98%，AUC 为 0.94。“超声输尿管跨越征”可准确预测输尿管结石的位置，显著提高超声检查的效率，并为后续治疗提供有价值的依据。
