Abdominal Computed Tomography-A New Tool for Predicting Recurrent Stone Disease
Abdominal Computed Tomography-A New Tool for Predicting Recurrent Stone Disease
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DOI：
10.1089/end.2013.0161
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发表时间：
2013-08-01
影响因子：
2.7
通讯作者：
Alcaraz, Antonio
中科院分区：
文献类型：
--
作者：
Ciudin, Alexandru;Pilar Luque, Maria;Alcaraz, Antonio
目的：为了评估CT识别的Randall斑块是否可用于预测结石病（SD）的复发，以确定一个临界点，可以确定一个高风险population.Materials和方法：回顾性研究的患者参加SD从2004年1月至2009年12月进行。研究人群为经腹部CT诊断的首次钙SD发作的患者。在非增强腹部CT图像上测量乳头尖端衰减，单位为Hounsfield单位（HU）。复发SD患者进行了确定; t检验，Pearson相关，和受试者工作特征（ROC）曲线analysis.Results：共543例进行了评估; 187符合标准，并纳入，49（26.2%）复发SD。平均随访时间：5年（3-7年）。复发组的乳头尖端衰减显著更高（46.2 HU vs 40.1 HU，P = 0.01），并且与发展SD的可能性密切相关（R = 0.83）。衰减>43 HU显示ROC曲线下面积= 0.87，敏感性= 77%，特异性= 84%，分离患者，复发SD的RR = 8.7。乳头数目>43 HU与SD复发相关（RR = 11.2，乳头数目>= 3 vs 43 HU）。结论：Randall斑块的存在可作为SD复发的预测指标。43 HU的临界点可用于识别高风险人群。
Purpose: To evaluate whether CT-identified Randall plaques can be used to foresee the recurrence of stone disease (SD); to define a cut point that could identify a high-risk population.Materials and Methods: A retrospective study of patients attended for SD from January 2004 to December 2009 was conducted. Study population was patients with a first episode of calcium SD that was diagnosed by abdominal CT. Papillae tip attenuation was measured in Hounsfield units (HU) on unenhanced abdominal CT images. Patients with recurrent SD were identified; t test, Pearson correlation, and receiver operating characteristic (ROC) curve analysis were used.Results: A total of 543 patients were evaluated; 187 fulfilled the criteria and were included, and 49 (26.2%) had recurrent SD. Mean follow-up: 5 years (3-7 years). Papillae tip attenuation was significantly higher in the recurrent group (46.2 HU vs 40.1 HU, P = 0.01) and correlated well with the possibility of developing SD (R = 0.83). Attenuation >43 HU showed a ROC curve area under the curve = 0.87 with sensitivity = 77% and specificity = 84% separating patients with a RR = 8.7 of development of recurrent SD. The number of papillae >43 HU correlated with recurrent SD (RR = 11.2 for >= 3 papillae vs 43 HU).Conclusions: The presence of the Randall plaques can be used as a marker for predicting SD recurrence. A cut point of 43HU could be used to identify a high-risk population.