Medical Imaging Department, King Fahad Hospital, Al-Madinah 42210, Saudi Arabia.
Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah 41477, Saudi Arabia.
Tomography. 2024 Jan 11;10(1):90-100. doi: 10.3390/tomography10010008.
The success rate of extracorporeal shock wave lithotripsy (ESWL) is influenced by various factors, including stone density, and is determined through computed tomography scans in terms of Hounsfield units (HU).
This retrospective single-center study was conducted in the King Fahad Hospital. Sixty-seven adult patients with renal and ureteric stones were selected randomly and enrolled in the study. Their ages ranged from 20 to 69 years. The patients were examined with non-contrast enhancement (NCCT) to assess the HU of their stones and were consequently treated with ESWL.
Of the 67 patients, 37.3% had stones that were completely fragmented, while 62.7% had stones that were partially fragmented. The HU, location of the stone, multiplicity of the stone, and patient age were found to be significant factors contributing to stone fragility (-values < 0.05). The HU data were found to have a positive significant linear correlation with serum calcium (r = 0.28, -value = 0.036), while serum acid had a negative correlation (r = -0.55, -value < 0.001). Thus, the probability of calcium-containing stone formation increases with increased HU. In contrast, uric acid stone formation likely develops with decreasing HU with serum uric acid. Renal stones in patients with diabetes mellitus and hypertension were not completely fragmented compared to those without clinical history.
Mean HU, location of the stone, laterality, stone status, and the number of ESWL sessions are the most significant factors affecting stone fragility. CT attenuation values can predict the composition of stones from serum calcium and uric acid examinations. Hypertension and diabetes mellitus are risk factors for renal stone fragmentation.
探讨体外冲击波碎石术(ESWL)的成功率受多种因素的影响,包括结石密度,并通过 CT 扫描的 Hounsfield 单位(HU)来确定。
这是一项回顾性单中心研究,在法赫德国王医院进行。随机选择并纳入了 67 例成人肾结石和输尿管结石患者,年龄 20-69 岁。对患者进行非增强 CT(NCCT)检查,以评估结石的 HU 值,随后进行 ESWL 治疗。
67 例患者中,37.3%的结石完全碎裂,62.7%的结石部分碎裂。HU 值、结石位置、结石数量和患者年龄是影响结石易碎性的显著因素(P 值<0.05)。HU 值与血清钙呈正显著线性相关(r=0.28,P 值=0.036),而血清酸呈负相关(r=-0.55,P 值<0.001)。因此,HU 值越高,含钙结石形成的可能性越大。相反,血清尿酸水平越低,尿酸结石形成的可能性越大。与无临床病史的患者相比,患有糖尿病和高血压的患者的肾结石不易完全碎裂。
平均 HU 值、结石位置、结石侧别、结石状态和 ESWL 次数是影响结石易碎性的最重要因素。CT 衰减值可以通过血清钙和尿酸检查来预测结石的成分。高血压和糖尿病是肾结石碎裂的危险因素。