Celik Serdar, Sefik Ertugrul, Basmacı Ismail, Bozkurt Ibrahim Halil, Aydın Mehmet Erhan, Yonguc Tarık, Degirmenci Tansu
Department of Urology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
Department of Basic Oncology, Institute of Oncology, Dokuz Eylul University, 35340, Izmir, Turkey.
Int Urol Nephrol. 2018 Aug;50(8):1397-1405. doi: 10.1007/s11255-018-1929-3. Epub 2018 Jul 6.
The purpose of the study was to investigate the predictive value of stone measurements by including a novel method on non-contrast computed tomography (NCCT) images for stone composition.
We retrospectively evaluated patients who had stone analysis, NCCT images, and underwent percutaneous nephrolithotomy between 2013 and 2016. Patient characteristics, stone measurements on NCCT images, and stone analysis results were evaluated. Hounsfield unit (HU) values (maximum (HU), minimum (HU), and average (HU) of HU values) were investigated on NCCT images. HU was calculated as the difference between the HU and the HU values. Patients were divided into seven stone groups and data were compared. Then patients were separately divided into two groups according to mineral complexity (mono-mineral and multi-mineral groups) and calcium-based (calcium and other stone groups) evaluation.
In the study, 115 patients were evaluated. Age, gender, HU, HU, and HU were significantly different between the stone groups. HU and HU were found to be 341.5 HU (AUC = 0.719, p = 0.017) and 1051.5 HU (AUC = 0.701, p = 0.029) as cut-off, respectively. Seventy of 72 > 341.5 HU patients and 64 of 67 > 1051.5 HU patients had multi-mineral stones (p = 0.001, OR 9.26, and p = 0.028, OR 4.27), respectively. In multivariate analysis, > 341.5 HU rate was significantly higher in multi-mineral and calcium stone groups; HU was also significantly higher in the calcium stone group.
HU and HU were significant predictors of mineral complexity. HU of < 341.5 HU showed 81.8% sensitivity and 67.2% specificity for identification of mono-mineral stones.
本研究的目的是通过在非增强计算机断层扫描（NCCT）图像上采用一种新方法测量结石，来探讨其对结石成分的预测价值。
我们回顾性评估了2013年至2016年间接受结石分析、NCCT图像检查并接受经皮肾镜取石术的患者。评估患者特征、NCCT图像上的结石测量值以及结石分析结果。在NCCT图像上研究亨氏单位（HU）值（HU值的最大值、最小值和平均值）。HU计算为HU与HU值之间的差值。将患者分为七个结石组并比较数据。然后根据矿物质复杂性（单矿物质和多矿物质组）和钙基（钙结石和其他结石组）评估将患者分别分为两组。
本研究共评估了115例患者。结石组之间的年龄、性别、HU、HU和HU存在显著差异。发现HU和HU的截断值分别为341.（此处原文可能有误，推测为341.5）HU（AUC = 0.719，p = 0.017）和1051.5 HU（AUC = 0.701，p = 0.029）。72例HU>341.5 HU的患者中有70例有多矿物质结石，67例HU>1051.5 HU的患者中有64例有多矿物质结石（p = 0.001，OR 9.26；p = 0.028，OR 4.27）。在多因素分析中，多矿物质结石组和钙结石组中>341.5 HU的比例显著更高；钙结石组中的HU也显著更高。
HU和HU是矿物质复杂性的重要预测指标。HU<341.5 HU对识别单矿物质结石的敏感性为81.8%，特异性为67.2%。
