Assessment of Hounsfield Units and Factors Associated with Fragmentation of Renal Stones by Extracorporeal Shock Wave Lithotripsy: A Computerized Tomography Study.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Tomography Pub Date : 2024-01-11 DOI:10.3390/tomography10010008

Abdallah Saud Alharbi, Moawia Gameraddin, Awadia Gareeballah, Zahra Jibril Shrwani, Moa'ath Abdullah Sindi, Hassan Ibrahim Alsaedi, Abdulaziz A Qurashi, Khalid M Aloufi, Abdullah Fahad A Alshamrani, Amel F Alzain

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Abstract

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).

Materials and methods: 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.

Results: 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 (p-values < 0.05). The HU data were found to have a positive significant linear correlation with serum calcium (r = 0.28, p-value = 0.036), while serum acid had a negative correlation (r = -0.55, p-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.

Conclusions: 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.

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体外冲击波碎石术碎裂肾结石的 Hounsfield 单位和相关因素评估：计算机断层扫描研究。

体外冲击波碎石术（ESWL）的成功率受包括结石密度在内的各种因素的影响，并通过计算机断层扫描的 Hounsfield 单位（HU）来确定：这项回顾性单中心研究在法赫德国王医院进行。研究随机选取了 67 名患有肾结石和输尿管结石的成年患者。他们的年龄从 20 岁到 69 岁不等。患者接受了非对比增强（NCCT）检查，以评估结石的HU值，并随后接受了ESWL治疗：67名患者中，37.3%的结石完全碎裂，62.7%的结石部分碎裂。HU值、结石位置、结石的多发性和患者年龄是导致结石破碎的重要因素（P值小于0.05）。研究发现，HU 数据与血清钙呈显著的线性正相关（r = 0.28，p 值 = 0.036），而血清酸呈负相关（r = -0.55，p 值 < 0.001）。因此，含钙结石形成的概率随着 HU 的增加而增加。与此相反，尿酸结石的形成可能随着 HU 值的降低和血清尿酸的升高而发生。与无临床病史者相比，糖尿病和高血压患者的肾结石并不完全碎裂：平均 HU 值、结石位置、侧位、结石状态和 ESWL 治疗次数是影响结石脆性的最重要因素。CT衰减值可通过血清钙和尿酸检查预测结石的成分。高血压和糖尿病是肾结石碎裂的危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.