Bagcilar Medical Bulletin (Jun 2022)
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.Method:One hundred-six 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. While measuring the density of the stones, 3 region of interest (ROIs) were placed in different parts of the stones. The value with the highest Hounsfield unite (HU) value was determined as the density of the stone.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 type groups 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 noncontrast 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.
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