【摘要】 泌尿系统疾病主要包括泌尿系结石、肾细胞癌、膀胱癌、前列腺癌及前列腺增生等，严重影响患者健康。能量CT作为一种先进成像技术，不仅可提供常规解剖信息，其虚拟单能图像、物质分离成像技术、有效原子序数及能谱曲线等后处理工具，还能通过定量分析实现结石成分精准鉴别（如尿酸与非尿酸结石鉴别效能近100%）、肿瘤良恶性鉴别及分期分级（如提高膀胱癌肌层浸润判断准确率至84.1%）。本篇综述系统分析了能量CT的设备分类、核心后处理工具的技术原理，并重点阐述其在泌尿系结石检测与成分分析，肾细胞癌、膀胱癌、前列腺癌等肿瘤的诊断、鉴别诊断及分期中的研究进展，同时指出当前技术在小结石（<3 mm）漏诊、设备成本较高等方面的局限性。能量CT为泌尿系统疾病的精准诊疗提供了重要支撑，具有显著的临床应用价值。更多还原

【Abstract】 Urological system diseases mainly include urinary calculi, renal cell carcinoma, bladder cancer, prostate cancer, and benign prostatic hyperplasia, which severely affect patients’ health. As an advanced imaging technique, energy computed tomography(energy CT) not only provides conventional anatomical information but also features advanced post-processing tools such as virtual monoenergetic images, material decomposition imaging technologies, effective atomic numbers, and spectral curves. Through quantitative analysis, it enables accurate identification of calculus components(e.g., nearly 100% efficacy in distinguishing uric acid from non-uric acid stones), differentiation of benign and malignant tumors, and tumor staging and grading(e. g., improving the accuracy of judging bladder cancer muscle invasion to 84.1%). This review systematically analyzes the classification of energy CT devices and the technical principles of core post-processing tools, with a focus on elaborating its research progress in the detection and component analysis of urinary calculi, as well as the diagnosis, differential diagnosis, and staging of tumors such as renal cell carcinoma, bladder cancer, and prostate cancer. It also points out the limitations of current technologies, including missed diagnosis of small stones(<3 mm) and high equipment costs. Energy CT provides important support for the precise diagnosis and treatment of urological diseases and has significant clinical application value.更多还原