Tellez Martínez-Fornés M, Burgos Revilla F J, Sáez Garrido J C, Soria Descalzo J, Barbero González J, Sánchez Corral J, Minaya Minaya A, Vallejo Herrador J
Servicio de Urología, Hospital Severo Ochoa, Madrid.
Actas Urol Esp. 1997 Feb;21(2):89-99.
Pre-treatment knowledge of the lithiasic composition can be useful to design the most appropriate therapeutic scheme for each kind of stone. The relationship between the stone's densitometry information provided by the different imaging techniques, conventional radiology (RX), computerized axial tomography (CAT) and dual energy radiographic densitometry (DO) is analyzed, as well as the elemental composition determined by the microanalysis of fragments obtained post-lithotrity using a scanning electronic microscope (SEM) associated to X-ray dispersion energy (XDE). 60 stones, 12 for each pure composition selected (calcium oxalate mono and dihydro, phosphocarbonate, magnesium ammonium phosphate and uric acid), were studied with XR, CAT and DO and were later subjected to lithofragmentation in vitro. Fragments analysis was carried out post-lithotrity with SEM associated to XDE. The X-ray does not allow to establish the composition of some calculi. CAT quantifies the mineral contents of the oxalocalcic and infective calculi and differentiates the uric acid from the other compositions because the mean density values are under 500 Hounsfield Units. DO evaluates the lithiasic content in phosphocarbonate salts which are structurally similar to bone hydroxyapatite.
治疗前了解结石成分有助于为每种结石设计最合适的治疗方案。分析了不同成像技术（传统放射学（RX）、计算机断层扫描（CAT）和双能X线骨密度仪（DO））提供的结石密度测量信息之间的关系，以及使用与X射线能谱仪（XDE）相关联的扫描电子显微镜（SEM）对体外冲击波碎石术后获得的结石碎片进行微量分析所确定的元素组成。选取了60颗结石，每种纯成分（一水草酸钙、二水草酸钙、磷酸碳酸盐、磷酸镁铵和尿酸）各12颗，分别采用XR、CAT和DO进行研究，随后进行体外碎石。碎石术后用与XDE相关联的SEM对碎片进行分析。X射线无法确定某些结石的成分。CAT可对草酸钙结石和感染性结石的矿物质含量进行量化，并将尿酸与其他成分区分开来，因为其平均密度值低于500亨氏单位。DO可评估结构与骨羟基磷灰石相似的磷酸碳酸盐盐类中的结石含量。
