Magnuson William J, Tomera Kevin M, Lance Raymond S
Alaska Urological Associates, 1200 Airport Heights, Suite 101, Anchorage, AK 99508, USA.
Alaska Med. 2005 Jul-Sep;47(2):6-9.
Extracorporeal shockwave lithotripsy (ESWL) is a commonly used non-invasive treatment for urolithiasis. Helical CT scans provide much better and detailed imaging of the patient with urolithiasis including the ability to measure density of urinary stones. In this study we tested the hypothesis that density of urinary calculi as measured by CT can predict successful ESWL treatment. 198 patients were treated at Alaska Urological Associates with ESWL between January 2002 and April 2004. Of these 101 met study inclusion with accessible CT scans and stones ranging from 5-15 mm. Follow-up imaging demonstrated stone freedom in 74.2%. The overall mean Houndsfield density value for stone-free compared to residual stone groups were significantly different ( 93.61 vs 122.80 p < 0.0001). We determined by receiver operator curve (ROC) that HDV of 93 or less carries a 90% or better chance of stone freedom following ESWL for upper tract calculi between 5-15mm.
体外冲击波碎石术（ESWL）是治疗尿石症常用的非侵入性方法。螺旋CT扫描能为尿石症患者提供更好、更详细的成像，包括测量尿路结石密度的能力。在本研究中，我们检验了以下假设：通过CT测量的尿结石密度可以预测ESWL治疗的成功率。2002年1月至2004年4月期间，阿拉斯加泌尿协会对198例患者进行了ESWL治疗。其中101例符合研究纳入标准，有可获取的CT扫描结果，结石大小在5 - 15毫米之间。随访成像显示结石清除率为74.2%。结石清除组与残留结石组的总体平均亨氏密度值有显著差异（93.61对122.80，p < 0.0001）。我们通过受试者工作特征曲线（ROC）确定，对于5 - 15毫米的上尿路结石，ESWL治疗后亨氏密度值（HDV）为93或更低时，结石清除的几率为90%或更高。
