Clinical Study On The Value Of Rapid KV-switching Dual Energy CT Combined With Metabolic Level In The Diagnosis And Treatment Of Urinary Calculi

Objective:To investigate energy spectrum CT instantaneous dual-energy imaging technology to analyze the accuracy of components of urinary stones in vivo,and to integrate serum electrolyte,urine PH value and Specific gravity（SG）to guide the treatment of stones.Methods:106 patients diagnosed as urolithiasis by B-ultrasound or X-ray in our hospital were selected as the calculus group.Urological scanning was performed with energy spectrum CT before surgery,and stone components were identified by effective atomic number combined with histogram.After removing stone,the stone composition analyzed by infrared spectroscopy served as the gold standard.Then the consistency identified by the two methods was analyzed.In the control group,109non-calculous patients hospitalized in the same period were analyzed to see whether there were differences in serum sodium（Na）,potassium（K）,calcium（Ca）,chlorine（CI）,CO₂-CP,urine SG and urine PH.Result:The Kappa consistency test results showed that the two kinds of method for identifying stone type had good consistency（Kappa=0.846,P<0.01）.The paired chi square test results showed that the difference of the two methods for identifying the stone type had no statistical significance（χ²=1.702,P=0.790）.The mean effective atomic number of energy spectrum CT of stones in the 106 cases in the group was15.71 for calcium phosphate stones,14.08 for calcium carbonate stones,11.25 for cystine stones,9.5 for magnesium ammonium phosphate stones and 6.9 for uric acid stones,all of which had significant differences among the groups.Serum Na,Ca,CI and SG levels in urolithiasis group were higher than those in non-urolithiasis group（P<0.05）,serum K and CO₂-CP levels lower in urolithiasis group than those in non-urolithasis group（P<0.05）.Logistic regression analysis showed thatβvalue of serum Na and K was 0.17（P<0.05）and-1.35（P<0.01）respectively.Conclusion:Effective atomic number combined with histogram can effectively analyze stone components.There are significant differences in serum electrolyte,urine SG and urine PH between the stone group and the control group,and serum sodium plays an important role in the pathogenesis of urinary stones.