Stone heterogeneity index as the standard deviation of Hounsfield units: A novel predictor for shock-wave lithotripsy outcomes in ureter calculi

被引:54
作者
Lee, Joo Yong [1 ]
Kim, Jae Heon [2 ]
Kang, Dong Hyuk [1 ]
Chung, Doo Yong [1 ]
Lee, Dae Hun [1 ]
Jung, Hae Do [3 ]
Kwon, Jong Kyou [4 ]
Cho, Kang Su [5 ]
机构
[1] Yonsei Univ, Coll Med, Urol Sci Inst, Dept Urol,Severance Hosp, Seoul, South Korea
[2] Soonchunhyang Univ, Coll Med, Seoul Hosp, Dept Urol, Seoul, South Korea
[3] Incheon Red Cross Hosp, Dept Urol, Inchon, South Korea
[4] Yonsei Univ Hlth Syst, Severance Check Up, Dept Urol, Seoul, South Korea
[5] Yonsei Univ, Coll Med, Urol Sci Inst, Dept Urol,Gangnam Severance Hosp, Seoul, South Korea
关键词
COMPUTED-TOMOGRAPHY PREDICT; URINARY STONE; ATTENUATION VALUE; DISTANCE; SKIN; DENSITY; FRAGILITY; SUCCESS;
D O I
10.1038/srep23988
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
We investigated whether stone heterogeneity index (SHI), which a proxy of such variations, was defined as the standard deviation of a Hounsfield unit (HU) on non-contrast computed tomography (NCCT), can be a novel predictor for shock-wave lithotripsy (SWL) outcomes in patients with ureteral stones. Medical records were obtained from the consecutive database of 1,519 patients who underwent the first session of SWL for urinary stones between 2005 and 2013. Ultimately, 604 patients with radiopaque ureteral stones were eligible for this study. Stone related variables including stone size, mean stone density (MSD), skin-to-stone distance, and SHI were obtained on NCCT. Patients were classified into the low and high SHI groups using mean SHI and compared. One-session success rate in the high SHI group was better than in the low SHI group (74.3% vs. 63.9%, P = 0.008). Multivariate logistic regression analyses revealed that smaller stone size (OR 0.889, 95% CI: 0.841-0.937, P < 0.001), lower MSD (OR 0.995, 95% CI: 0.994-0.996, P < 0.001), and higher SHI (OR 1.011, 95% CI: 1.008-1.014, P < 0.001) were independent predictors of one-session success. The radiologic heterogeneity of urinary stones or SHI was an independent predictor for SWL success in patients with ureteral calculi and a useful clinical parameter for stone fragility.
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页数:7
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