Bigum Lene Hyldgaard, Ulriksen Peter Sommer, Omar Omar Salah
Department of Urology, Herlev Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.
CT Innovation Unit at Department of Radiology, Herlev Hospital, Herlev Ringvej 75, Herlev, Denmark.
Urolithiasis. 2016 Oct;44(5):451-7. doi: 10.1007/s00240-016-0864-y. Epub 2016 Feb 25.
This study describes and evaluates the use of non-contrast enhanced computerized tomography (NCCT) before and after extracorporeal shockwave lithotripsy (SWL). Computer measured stone volume was used as an exact measurement for treatment response. 81 patients received SWL of kidney stones at Herlev Hospital between April 2013 and January 2014 and follow-up was possible in 77 (95 %) patients. NCCT was used before and after treatment. Treatment response was expressed as a reduction of the stone volume. Stone characteristics as the stone volumes, HU, SSD and localization were measured by radiologist using a vendor non-specific computer program. Complications, patient characteristics and additional treatment were registered. On average, 5858 shocks were given each patient. The follow-up NCCT was performed 24 days after treatment. It was possible to calculate the stone volume in 88 % of the patients-the remaining 12 % it was not possible due to stone disintegration. The stone free rate was 22 %. The average relative reduction in stone burden was 62 %. Only 8 % of the patients were radiological non-responders. Steinstrasse was observed in 13 (17 %) and 28 (36 %) patients had additional treatment performed. Irradiation dose per NCCT was 2.6 mSv. Stone volume could be calculated in most patients. The relative reduction in stone burden after treatment was 62 %. The stone volume was redundant when evaluating stone free patients, but in cases of partial response it gave an exact quantification, to be used in the further management and follow-up of the patients.
本研究描述并评估了体外冲击波碎石术（SWL）前后非增强计算机断层扫描（NCCT）的应用。计算机测量的结石体积被用作治疗反应的精确测量指标。2013年4月至2014年1月期间，81例患者在赫勒夫医院接受了肾结石的SWL治疗，77例（95%）患者能够进行随访。治疗前后均使用了NCCT。治疗反应以结石体积的减少来表示。放射科医生使用供应商非特定的计算机程序测量结石特征，如结石体积、HU、SSD和定位。记录并发症、患者特征和额外治疗情况。每位患者平均接受5858次冲击。治疗后24天进行随访NCCT。88%的患者能够计算结石体积，其余12%由于结石崩解无法计算。结石清除率为22%。结石负荷的平均相对减少率为62%。只有8%的患者为放射学无反应者。13例（17%）患者观察到石街形成，28例（36%）患者接受了额外治疗。每次NCCT的辐射剂量为2.6 mSv。大多数患者能够计算结石体积。治疗后结石负荷的相对减少率为62%。在评估结石清除的患者时，结石体积可能多余，但在部分反应的情况下，它能给出精确的量化结果，用于患者的进一步管理和随访。
