基于非增强计算机断层扫描的输尿管结石参数对体外冲击波碎石术疗效的影响
Non-Contrast Computed Tomography Scan Based Parameters of Ureteric Stones Affecting the Outcome of Extracorporeal Shock Wave Lithotripsy.
作者信息
Waqas Muhammad, Ayaz Khan Mohammad, Waqas Iqbal Muhammad, Akbar Mian Khalid, Saqib Imad-Ud-Din, Akhter Saeed
机构信息
Department of Urology, Shifa International Hospital, Islamabad, Pakistan.
Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan.
出版信息
Cureus. 2017 May 5;9(5):e1227. doi: 10.7759/cureus.1227.
OBJECTIVE
To compare the non-contrast computed tomography (NCCT) scan-based parameters of ureteric stones affecting the outcome of extracorporeal shock wave lithotripsy (ESWL).
MATERIALS AND METHODS
We retrospectively evaluated the pre-procedure NCCT of 74 patients who had ESWL for solitary ureteric calculi of 5-20 mm in diameter. We assessed the age, sex, basal metabolic index (BMI), laterality, location, presence of double 'J' (DJ) stent, skin to stone distance (SSD), stone maximum diameter, Hounsfield unit (HU), Hounsfield density (HD), area, and volume. All those who had no stone on follow-up imaging within 30 days were declared successful while those who had residual stone were declared failures.
RESULTS
The overall success rate was 78% (58/74). Sixty (81.1%) patients were male. The success of ESWL was correlated with lower SSD, Hounsfield units (HU) and Hounsfield density (HD). However, in multivariate analysis, SSD, Hounsfield unit, and stone area showed correlation with success of procedure but Hounsfield density failed to show correlation. The success rate in patients with stone HU <500, 500-1000 and >1000 were 93.9%, 69%, and 58.3%, respectively. Patients with lower BMI (<30 kg/m) and HD (<76 HU/mm) were more prone towards success of the procedure than those with higher BMI (>30 kg/m) and higher HD (>76 HU/mm).
CONCLUSION
BMI, SSD, stone Hounsfield units and Hounsfield unit density were strong predictors of outcome of ESWL for ureteric stone.
目的
比较基于非增强计算机断层扫描（NCCT）的输尿管结石参数对体外冲击波碎石术（ESWL）疗效的影响。
材料与方法
我们回顾性评估了74例因直径5 - 20 mm的孤立性输尿管结石接受ESWL治疗患者的术前NCCT。我们评估了年龄、性别、基础代谢指数（BMI）、结石位于左侧还是右侧、结石位置、是否存在双J（DJ）支架、皮肤至结石距离（SSD）、结石最大直径、亨氏单位（HU）、亨氏密度（HD）、面积和体积。所有在30天内随访影像检查无结石残留的患者判定为治疗成功，有残留结石的患者判定为治疗失败。
结果
总体成功率为78%（58/74）。60例（81.1%）患者为男性。ESWL治疗成功与较低的SSD、亨氏单位（HU）和亨氏密度（HD）相关。然而，在多因素分析中，SSD、亨氏单位和结石面积与治疗成功相关，但亨氏密度未显示出相关性。结石HU<500、500 - 1000和>1000的患者成功率分别为93.9%、69%和58.3%。BMI较低（<30 kg/m²）和HD较低（<76 HU/mm³）的患者比BMI较高（>30 kg/m²）和HD较高（>76 HU/mm³）的患者更易治疗成功。
结论
BMI、SSD、结石亨氏单位和亨氏单位密度是输尿管结石ESWL治疗疗效的有力预测指标。
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