Urinary stone density measured on non-contrast computed tomography correlated with success rate by extracorporeal shockwave lithotripsy treatment

Chalcheska, Slavica and Stojovska-Jovanovska, Elizabeta and Stojanoski, Ivica and Kostadinovski, Vlatko and Dejanova-Panev, Sandra and Veljanovska-Prgova, Biljana (2021) Urinary stone density measured on non-contrast computed tomography correlated with success rate by extracorporeal shockwave lithotripsy treatment. Jurnal of Morphological Sciences, 4 (1). pp. 54-60. ISSN 2545-4706

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Abstract

Measurements of urinary calculi density in Hounsfield Unit, stone size, site by non-contrast
computed tomography (NCCT), correlated with success rate by extracorporeal shock wave lithotripsy
(ESWL) outcome in complete fragmentation, fragments less than 5 mm or incomplete fragmentation.
Retrospective study comprising 40 patients with urinary calculus of 10-20 mm divided into two groups
(10-15 mm and 16-20 mm), with defining stone location, site and attenuation measured in Hounsfield
Unit (HU), divided into three groups:1- Soft stones <6500HU; 2- Medium stones 650-1200HU; 3- Hard
stones >1200HU. All treated from 4000-4500 shock waves. Success in initial stone disintegration was
defined with a plain film X-ray in 5-6 weeks.
Completely disintegrated calculus was confirmed in 31 (77.5%), up to 5 mm fragments in 3
(7.5%) and unsuccessful in 6 (15.0%) patients. The percentage difference between complete
disintegration versus up to 5 mm fragments or failed disintegration was extremely statistically significant
for p<0.05 (Difference test, p=0.001). High percentage calculated after one treatment in 2- Medium stone
group 650-1200HU in 15 (60%) patients, in 6 (24%) of the 1-Soft stone group, and in 3-Hard stone group
in 4 (16%).
Percentage difference between the 2-Medium stone group after one ESWL treatment versus the
1-Soft stone group and 3-Hard stone group was statistically significant for p<0.05 (Difference test, p=0.
0162). Study findings show that the attenuation value of stones can predict successful outcome of ESWL
treatment for the upper urinary tract, and it has a greater impact on ESWL outcome than the stone size
and site.
Keywords: non-contrast computed tomography (NCCT), Hounsfield Unit (HU), extracorporeal
shockwave lithotripsy (ESWL), disintegration, attenuation

Item Type:	Article
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Ivica Stojanoski
Date Deposited:	19 Feb 2024 12:20
Last Modified:	19 Feb 2024 12:20
URI:	https://eprints.ugd.edu.mk/id/eprint/33673

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