Dretler S P, Polykoff G
Kidney Stone Center, Massachusetts General Hospital, Boston, USA.
J Urol. 1996 Mar;155(3):828-33. doi: 10.1016/s0022-5347(01)66319-5.
We determined specific radiographic morphological patterns of crystallographically analyzed pure and mixed calcium oxalate dihydrate and calcium oxalate monohydrate urinary calculi.
A total of 86 greater than 1 cm. calculi crystallographically analyzed as pure calcium oxalate monohydrate, calcium oxalate dihydrate or admixtures of the 2 types was studied to determine whether various forms of calcium oxalate differed in radiographic morphology.
Four distinct radiographic patterns could be identified by plain film roentgenography: group 1--14 patients with smooth edged, homogeneously dense calculi, some with dentate shapes (12 had pure calcium oxalate monohydrate stones), group 2--33 with multinodular calculi with irregular edges and variegated areas of more and less radiodensity (32 had greater than 60% calcium oxalate monohydrate), group 3--33 with a uniform, stippled pattern, often with identifiable radial striations, and with a larger amount of calcium oxalate dihydrate than groups 1 or 2, and group 4--6 with poorly radiodense, loosely aggregated crystals with a lacy structure.
At least 4 patterns of calcium oxalate stones are recognizable by plain film roentgenography. Because the fragility of calcium oxalate calculi is determined by the relative calcium oxalate monohydrate and dihydrate content, pretreatment recognition of these radiographic patterns may affect the selection of a therapeutic modality.
我们确定了经晶体分析的纯二水合草酸钙和一水合草酸钙以及混合性草酸钙尿结石的特定放射学形态模式。
对总共86颗直径大于1厘米、经晶体分析为纯一水合草酸钙、二水合草酸钙或这两种类型混合物的结石进行研究，以确定各种形式的草酸钙在放射学形态上是否存在差异。
通过平片X线摄影可识别出四种不同的放射学模式：第1组——14例患者，结石边缘光滑、密度均匀，有些呈齿状（12例为纯一水合草酸钙结石）；第2组——33例，结石为多结节状，边缘不规则，有密度高低不一的斑驳区域（32例一水合草酸钙含量大于60%）；第3组——33例，呈均匀的点状模式，常可见放射状条纹，二水合草酸钙含量比第1组或第2组多；第4组——6例，结石密度低，晶体松散聚集，呈花边状结构。
通过平片X线摄影至少可识别出四种草酸钙结石模式。由于草酸钙结石的易碎性由一水合草酸钙和二水合草酸钙的相对含量决定，术前识别这些放射学模式可能会影响治疗方式的选择。
