Division of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Section of Endourology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Int Braz J Urol. 2014 Mar-Apr;40(2):212-9. doi: 10.1590/S1677-5538.IBJU.2014.02.11.
We developed a stereotactic device to guide the puncture for percutaneous nephrolithotripsy, which uses the distance from the target calyx to its perpendicular point on skin (SCD) to calculate the needle´s entry angle. This study seeks to validate the use of measurements obtained by ultrasound (US) and computerized tomography (CT) for needle´s entry angle calculation and to study factors that may interfere in this procedure.
Height, weight, abdominal circumference, CT of the urinary tract in dorsal decubitus (DD) and ventral decubitus (VD), and US of the kidneys in VD were obtained from thirty-five renal calculi patients. SCD obtained were compared and correlated with body-mass index (BMI).
BMI was 28.66 ± 4.6 Kg/m2. SCD on CT in DD was 8.40 ± 2.06cm, in VD was 8.32 ± 1.95cm, in US was 6.74 ± 1.68cm. SCD measured by US and CT were statistically different (p < 0.001), whereas between CT in DD and VD were not. SCD of the lower calyx presented moderate correlation with BMI.
SCD obtained by CT in ventral and dorsal decubitus may be used for calculation of the needle´s entry angle. SCD obtained by US cannot be used. A rule for the correlation between BMI and the SCD could not be determined.
我们开发了一种立体定向装置来引导经皮肾镜碎石术的穿刺,该装置使用目标肾盂到其在皮肤上的垂直点(SCD)的距离来计算针头的进入角度。本研究旨在验证使用超声(US)和计算机断层扫描(CT)测量值计算针头进入角度的方法,并研究可能影响该过程的因素。
从 35 例肾结石患者中获得身高、体重、腹围、仰卧位和俯卧位尿路 CT 以及俯卧位肾脏 US。比较并比较 SCD 与体重指数(BMI)的相关性。
BMI 为 28.66 ± 4.6 Kg/m2。DD 位 CT 的 SCD 为 8.40 ± 2.06cm,VD 位 CT 的 SCD 为 8.32 ± 1.95cm,VD 位 US 的 SCD 为 6.74 ± 1.68cm。US 和 CT 测量的 SCD 有统计学差异(p < 0.001),而 DD 和 VD 位 CT 之间无差异。下盏 SCD 与 BMI 呈中度相关。
仰卧位和俯卧位 CT 获得的 SCD 可用于计算针头的进入角度。US 获得的 SCD 不能使用。未能确定 BMI 与 SCD 之间的相关性规则。