Department of Urology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
The Second Clinical Medical School of Zhengzhou University, No. 2 Jingba Road, Jinshui District, Zhengzhou, 450000, China.
Urolithiasis. 2024 Aug 23;52(1):120. doi: 10.1007/s00240-024-01616-w.
The purpose of the study was to explore the predictive value of preoperative quantitative NCCT analysis for proximal and middle ureteral stone impaction. Data of 128 patients who diagnosed with proximal and middle ureteral stones were analyzed. Stone size, upper diameter of the ureter(D1), lower diameter of the ureter (D2), CT attenuation of the ureter above the stone (HA, 'HU above'), CT attenuation of the ureter below the stone (HB, 'HU below'), CT attenuation values of the stone's proximal segments (C1), CT attenuation values of the stone's distal segments (C2), and ureteral wall thickness(UWT)were recorded. Logistic regression was used to perform univariate and multivariate analyses of the data to determine the independent predictors of proximal and middle ureteral stone impaction. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive performance. Among the 128 patients, 52 (40.6%) had impacted stones, while 76 (59.4%) did not. Multivariate logistic regression analysis showed that stone size > 9.45 mm (OR = 1.372, 95% CI = 1.071-1.756, P = 0.012), UWT > 3.22 mm (OR = 4.217, 95% CI = 2.165 ~ 8.213, P < 0.001)、DDR > 2.10 (OR = 4.901, 95% CI = 1.797 ~ 13.365, P = 0.002)and HBA > 1.58 (OR = 5.237,95% CI = 1.502 ~ 18.259, P = 0.009)were independent risk factors for predicting ureteral stone impaction. In conclusion, stone size, UWT, DDR, and HBA show crucial predictive value for impaction of stones.
研究目的是探讨术前定量 CT 分析对输尿管中上段结石嵌顿的预测价值。分析了 128 例被诊断为输尿管中上段结石的患者的数据。记录了结石大小、输尿管上段直径(D1)、输尿管下段直径(D2)、结石上方输尿管 CT 值(HA，“HU above”)、结石下方输尿管 CT 值(HB，“HU below”)、结石近端 CT 值(C1)、结石远端 CT 值(C2)和输尿管壁厚度(UWT)。采用单因素和多因素 logistic 回归分析数据，确定输尿管中上段结石嵌顿的独立预测因素。绘制受试者工作特征(ROC)曲线评估预测性能。在 128 例患者中，52 例(40.6%)存在嵌顿结石，76 例(59.4%)不存在嵌顿结石。多因素 logistic 回归分析显示，结石大小>9.45mm(OR=1.372，95%CI=1.0711.756，P=0.012)、UWT>3.22mm(OR=4.217，95%CI=2.1658.213，P<0.001)、DDR>2.10(OR=4.901，95%CI=1.79713.365，P=0.002)和 HBA>1.58(OR=5.237，95%CI=1.50218.259，P=0.009)是预测输尿管结石嵌顿的独立危险因素。结论，结石大小、UWT、DDR 和 HBA 对结石嵌顿具有重要的预测价值。
