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结石密度变异系数在判定尿路结石冲击波碎石术成功率中的作用。

Role of variation coefficient of stone density in determining success of shock wave lithotripsy in urinary calculi.

作者信息

Iqbal Nadeem, Hasan Aisha, Iqbal Sajid, Noureen Sadaf, Akhter Saeed

机构信息

Department of Urology and Kidney Transplant, Shifa Intl Hospitals, Islamabad 44790, Pakistan.

Department of Urology, Pakistan Kidney and Liver Institute, Lahore 54000, Punjab, Pakistan.

出版信息

World J Nephrol. 2025 Mar 25;14(1):96946. doi: 10.5527/wjn.v14.i1.96946.

Abstract

BACKGROUND

Various stone factors can affect the net results of shock wave lithotripsy (SWL). Recently a new factor called variation coefficient of stone density (VCSD) is being considered to have an impact on stone free rates.

AIM

To assess the role of VCSD in determining success of SWL in urinary calculi.

METHODS

Charts review was utilized for collection of data variables. The patients were subjected to SWL, using an electromagnetic lithotripter. Mean stone density (MSD), stone heterogeneity index (SHI), and VCSD were calculated by generating regions of interest on computed tomography (CT) images. Role of these factors were determined by applying the relevant statistical tests for continuous and categorical variables and a value of < 0.05 was gauged to be statistically significant.

RESULTS

There were a total of 407 patients included in the analysis. The mean age of the subjects in this study was 38.89 ± 14.61 years. In total, 165 out of the 407 patients could not achieve stone free status. The successful group had a significantly lower stone volume as compared to the unsuccessful group ( < 0.0001). Skin to stone distance was not dissimilar among the two groups ( = 0.47). MSD was significantly lower in the successful group ( < 0.0001). SHI and VCSD were both significantly higher in the successful group ( < 0.0001).

CONCLUSION

VCSD, a useful CT based parameter, can be utilized to gauge stone fragility and hence the prediction of SWL outcomes.

摘要

背景

多种结石因素会影响冲击波碎石术(SWL)的最终结果。最近,一种名为结石密度变异系数(VCSD)的新因素被认为会对结石清除率产生影响。

目的

评估VCSD在判定尿路结石SWL成功与否中的作用。

方法

利用病历回顾来收集数据变量。患者接受使用电磁碎石机的SWL治疗。通过在计算机断层扫描(CT)图像上生成感兴趣区域来计算平均结石密度(MSD)、结石异质性指数(SHI)和VCSD。通过对连续变量和分类变量应用相关统计检验来确定这些因素的作用,P值<0.05被判定具有统计学意义。

结果

共有407例患者纳入分析。本研究中受试者的平均年龄为38.89±14.61岁。407例患者中共有165例未达到结石清除状态。成功组的结石体积明显低于未成功组(P<0.0001)。两组间皮肤到结石的距离无差异(P=0.47)。成功组的MSD明显更低(P<0.0001)。成功组的SHI和VCSD均明显更高(P<0.0001)。

结论

VCSD是一个基于CT的有用参数,可用于衡量结石易碎性,从而预测SWL的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1e/11755239/4f6fec64d02f/96946-g001.jpg

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