作为评估尿道曲的新参数,HUDmax:预测尿道显微镜性石症结果的关键评估
Utku Can1, Bilal Eryildirim1, Alper Coşkun1
1Department of Urology, Health Sciencies University, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul 34865, Türkiye.
Medicina (Kaunas, Lithuania)
|September 27, 2025
概括
在CT扫描上通过最大水平尿道位移 (HUDmax) 识别的尿道曲,阻碍了尿道透视性石 (URSL) 的成功. 在URSL程序中,HUDmax有效地预测了访问故障和较低的无结石率.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医疗成像医学成像
- 手术创新 在外科创新.
背景情况:
- 尿道曲可以阻碍内镜接入,并降低尿道镜性石 (URSL) 的成功率.
- 术前识别尿管曲是计划URSL手术的关键.
研究的目的:
- 引入和评估一个新的指标,最大水平尿道位移 (HUDmax),来自非对比CT扫描.
- 评估HUDmax在手术前识别尿道曲的预测价值及其对URSL成功的影响.
主要方法:
- 对1261名接受单个尿道结石治疗的患者进行了回顾性分析.
- 倾向得分匹配 (1:2) 以根据石材特征创建可比的队列.
- 评估HUDmax,尿道壁厚度和石头参数;进行了相关性和ROC分析.
主要成果:
- 半固体难以接近的组表现出明显更高的HUDmax值 (2.36毫米对1.2毫米).
- HUDmax强烈预测半刚性访问失败 (AUC:0.805) 和中度预测无石头状态 (AUC:0.697).
- 较高的HUDmax与增加的手术时间和需要二次手术相关.
结论:
- 严重的尿路曲是半刚性URSL成功的重要障碍.
- 来自非对比CT的新型HUDmax度量可以可靠地预测手术前的尿道扭曲.
- HUDmax为手术规划和改善URSL结果提供了一个有价值的工具.
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