Kalyenci Bedreddin, Çift Ali, Aydemir Ahmet Burak, Sulhan Hasan, Benlioğlu Can, Yücel Mehmet Özgür
Department of Urology, Faculty of Medicine, Adıyaman University, Adıyaman, 02040, Turkey.
Department of Radiology, Faculty of Medicine, Adıyaman University, Adıyaman, 02040, Turkey.
Sci Rep. 2025 May 9;15(1):16249. doi: 10.1038/s41598-025-01214-9.
This study aimed to investigate the predictive ability of Hounsfield unit (HU) measurements for microorganism growth observed microbiologically in stone cultures after stone surgery and to create a model by adding other predictive factors for predicting stone culture positivity. Patients who underwent percutaneous nephrolithotomy, retrograde intrarenal surgery, or ureteroscopy and had stone cultures performed were included in the study. Demographic and clinical data, including age, gender, body mass index, stone size, stone volume, hydronephrosis grade, stone location, energy used, presence of preoperative stent or nephrostomy, operation duration, midstream urine culture, renal pelvic urine culture, stone culture results, and postoperative fever and systemic inflammatory response syndrome criteria, were recorded. Non-contrast computed tomography images were used to measure the HU at the stone's core (HU), the proximal surface of the stone periphery in the collecting system (HU), the distal surface of the stone periphery in the collecting system (HU), and the average HU of the stone periphery (HU). Absolute and relative differences between these values were calculated. A total of 383 patients were included, with microorganism growth observed in the stone cultures of 75 patients (19.6%). Radiological cut-off values distinguishing stones with positive cultures included HU < 81.8, HU < 807.0, and HU > 179.5. Factors associated with a statistically significant increase in the likelihood of positive stone cultures included longer operation duration (odds ratio [OR] = 1.102, 95% confidence interval [CI]: 1.053-1.154, p < 0.001), higher preoperative hydronephrosis grade (OR = 1.898, 95% CI: 1.289-2.795, p < 0.001), and the presence of preoperative stents or nephrostomy (OR = 4.232, 95% CI: 1.551-11.543, p = 0.005) in addition to the identified radiological HU cut-off values. HU values, as a radiological parameter, can predict microorganism growth in stone cultures, enabling identification of patients at risk for postoperative infectious complications.
本研究旨在探讨亨氏单位（HU）测量值对结石手术后结石培养中微生物生长的预测能力，并通过添加其他预测因素建立一个预测结石培养阳性的模型。纳入接受经皮肾镜取石术、逆行肾内手术或输尿管镜检查并进行结石培养的患者。记录人口统计学和临床数据，包括年龄、性别、体重指数、结石大小、结石体积、肾积水分级、结石位置、使用的能量、术前是否放置支架或肾造瘘、手术时间、中段尿培养、肾盂尿培养、结石培养结果以及术后发热和全身炎症反应综合征标准。使用非增强计算机断层扫描图像测量结石核心处的HU（HU）、集合系统中结石周边近端表面的HU（HU）、集合系统中结石周边远端表面的HU（HU）以及结石周边的平均HU（HU）。计算这些值之间的绝对差异和相对差异。共纳入383例患者，75例患者（19.6%）的结石培养中观察到微生物生长。区分培养阳性结石的放射学临界值包括HU < 81.8、HU < 807.0和HU > 179.5。与结石培养阳性可能性在统计学上显著增加相关的因素包括手术时间延长（比值比[OR] = 1.102，95%置信区间[CI]：1.053 - 1.154，p < 0.001）、术前肾积水分级较高（OR = 1.898，95% CI：1.289 - 2.795，p < 0.001）以及除已确定的放射学HU临界值外，术前存在支架或肾造瘘（OR = 4.232，95% CI：1.551 - 11.543，p = 0.005）。HU值作为一种放射学参数，可以预测结石培养中的微生物生长，有助于识别有术后感染并发症风险的患者。
