CT值对ESWL成功率预测的研究

目的了解非增强螺旋CT的结石CT值对预测上尿路结石体外冲击波碎石（ESWL）后结石排空率的价值。方法对35例结石大小在0.5-1.5cm需行ESWL的上尿路单发结石患者先行非增强螺旋CT检查，并测定结石CT值，经ESWL后复查B超及腹平片检查，随访3个月，根据碎石屑残留与否，将35例患者分结石排空组及结石残留组（将残留碎石屑〈3mm者归入排空组）。统计学分析两组间患者的基本特征，结石CT值、能量冲击次数。结果结石排空者25例（71.4％），结石残留组10例（28.6％），总的结石排空组与残留组的结石平均CT值分别为（650±185）HU和（950±282）HU（t=5.463，P〈0.01），差异有统计学意义。结论非增强螺旋CT的结石CT值能预测体内上尿路结石ESWL后结石的粉碎率和排空率。CT值低者ESWL后结石容易被粉碎和易于排空；CT值高者结石的粉碎率和排空率明显下降。此类患者则可考虑选择输尿管镜下取石碎术、经皮肾穿刺取石碎术。

Study on prognosis of ESWL based on Hounsfield units in CT scan

Objective To study the value of the Hounsfield units,which were gotten in non-contrast helical computerized tomography(NCHCT) of upper urinary tract calculi,in prognosticating of the stone-free rate after extracorporeal shock wave lithotripsy(ESWL).Method A total of 35 case of single upper urinary tract calculi 0.5~1.5 cm in size underwent NCHCT measuring the Hounsfield units before ESWL to treat the calculi.Type-B ultrasonic scan and plain abdominal radiograph were reviewed regularly in the 3 months after ...