The Value of a Single Measurement of Calculus Density by Computed Tomography in Predicting the Composition of Stones and Its Use in Practice in Patients with Urolithiasis
Abstract
Objective: Urinary tract stones consist of many subtypes. Prior knowledge of the chemical composition of stones is a key factor in determining the fragility of the stone and determining the treatment and prophylactic approach to be applied to the patient. In this way, the group of patients who can receive medical treatment can be determined, this group of patients can be kept away from repetitive imaging procedures and the cost to be made by reimbursement institutions can be reduced. In this study, it is aimed to predict the stone type according to Hounsfield Unite (HU) values.
Materials and Methods: 106 patients between the ages of 18-70 who were diagnosed with urolithiasis and underwent biochemical analysis for these stones between 2013 and 2017 were included in the study. Non-contrast computed tomography images of the patients were analyzed retrospectively. Density measurements of calculi on computed tomography images at the workstation were made at the densest part of the calculus in the bone window preset, under standard magnification. Apart from density measurement, stone localization and maximum diameter were also determined. The measured values and the chemical analysis results of calculus were compared.
Results: According to the stone analysis results, 11 calcium phosphate, 18 calcium oxalate monohydrate-dihydrate, 42 calcium oxalate monohydrate, 10 cystine, 12 struvite, 13 uric acid stones were found. According to the measurement results, the density difference between the 6 stone groups was statistically significant (p=0.0001). No statistically significant difference was observed between the mean age of the stone types and the distribution of the sides (right-left) (p=0.284, p=0.747). A statistically significant difference was observed between the gender distributions of the stone type groups (p=0.037). There was a statistically significant difference between the distribution of stone sizes and types (p=0.0001).
Conclusion: Density measurements of urinary tract stones in non-contrast computed tomography are useful in recognizing their subtypes. Thus, uric acid stones can be determined and the patient can be referred to oral chemolysis treatment. This may enable the patient to avoid repetitive imaging procedures and interventional treatments.
Keywords: Kidney; Computed tomography; Oral Chemolysis; urolithiasis; uric acid stone
Key words: Kidney; Computed tomography; Oral Chemolysis; urolithiasis; uric acid stone
Anahtar kelimeler: Böbrek; Bilgisayarlı tomografi; Oral Kemoliz; Ürolitiazis; Ürik asit taşı
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