Assessment of Hounsfield Units and Factors Associated with Fragmentation of Renal Stones by Extracorporeal Shock Wave Lithotripsy: A Computerized Tomography Study
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
Affiliations
Abdallah Saud Alharbi
Medical Imaging Department, King Fahad Hospital, Al-Madinah 42210, Saudi Arabia
Moawia Gameraddin
Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah 41477, Saudi Arabia
Awadia Gareeballah
Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah 41477, Saudi Arabia
Zahra Jibril Shrwani
Medical Imaging Department, King Fahad Hospital, Al-Madinah 42210, Saudi Arabia
Moa’ath Abdullah Sindi
Medical Imaging Department, King Fahad Hospital, Al-Madinah 42210, Saudi Arabia
Hassan Ibrahim Alsaedi
Medical Imaging Department, King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia
Abdulaziz A. Qurashi
Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah 41477, Saudi Arabia
Khalid M. Aloufi
Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah 41477, Saudi Arabia
Abdullah Fahad A. Alshamrani
Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah 41477, Saudi Arabia
Amel F. Alzain
Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah 41477, Saudi Arabia
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 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.
