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Showing 2 results for Renal Stone
Association between some CT characteristics of renal stones and extracorporeal shockwave lithotripsy success rate
Saedi Daryoosh, Molavi Mohamad,
Volume 70, Issue 3 (6-2012)
Abstract

Background: Since non-contrast spiral CT (NCCT) is an imaging method of choice performed before extracorporeal shockwave lithotripsy (ESWL), we aimed to find the association between renal stone characteristics including stone density, location, volume, and skin-to-stone distance (SSD) on NCCT and ESWL success for a more efficient selection of patients for the procedure.

Methods: We retrospectively studied 100 patients having undergone initial ESWL for a solitary renal calculus of 0.5-2.5 cm. Stone size, location, density, and SSD were determined on pretreatment NNCT. The outcome was categorized as stone free, complete fragmentation (<5 mm), incomplete fragmentation (>5 mm) and unchanged, based on KUB radiography 2 weeks after ESWL.

Results: Of 100 patients, 32 were female and 68 were male with a mean age of 46.7 years. ESWL was successful in 55 and failure occurred in 45 patients. Sex (P=0.301), age (P=0.895) and SSD (P=4.06) were not associated with treatment success. Mean stone volume in ESWL success and failure groups, respectively were 531.4 and 930.5 mm3 and stone volume was statistically associated with treatment success (P=0.01). Mean stone density in ESWL success and failure groups were 545.7 and 962.3 HU, respectively and stone density was also associated with ESWL success (P<0.01). ESWL failure likelihood was 5 times greater in stones with a density >740 HU than smaller stones.

Conclusion: We strongly suggest performing densitometry in bone window for renal stones on pre-ESWL NCCT scanning and using an alternative treatment other than ESWL for stone densities greater than 740 HU.


Influencing factors in the comparison of renal stone size measurements between CT scan and ultrasound
Mohammad Reza Sasani , Leila Fazlollahpour , Mahdi Saeedi-Moghadam ,
Volume 81, Issue 5 (8-2023)
Abstract
Background: Ultrasound is widely used to detect renal stones. A no-contrast CT scan is the most accurate modality for stone examination. Considering that determining the size of a stone is the main criterion in treatment planning, the purpose of this study was to compare ultrasound and non-contrast CT scans in determining renal stone size.
Methods: In this cross-sectional study, 140 patients were assessed from June to October 2017 at Namazi Hospital of Shiraz University of Medical Sciences. A radiologist compared the CT scans of patients with their ultrasound images. The ultrasound and CT scan results in terms of stone size were assessed. The correlation rate of stone size in ultrasound and CT scans in different subgroups was assessed by categorizing the stone size into three subgroups. The impact of stone location and the CT window on measuring stone size were evaluated.
Results: The mean stone size measured by ultrasound and CT scan was 11.23±5.26 and 9.48±4.7mm, respectively, which was significantly different. The highest rate of correlation was observed in the stones>10mm (81%) and then in 5-10mm (69.3%). The lowest agreement was observed in stones <5mm (37.5%).
Conclusion: Using ultrasonography as a screening test or a primary test for detecting the renal stones is recommended. However, considering the importance of a precise assessment of stone size in choosing the treatment method and the limitations of sonography in the evaluation of small stones, a CT scan should be considered as a standard diagnostic tool if there is no contraindication. In CT images, the application of BW might underestimate the stone size in comparison to SW. Considering the results of previous studies, it is better to use magnified BW to assess the stone size on CT scan images. Although the axial view in a CT scan is more routine, for measuring the stone size it is better to use coronal or sagittal views together with axial views.

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