The value of performing dual-source dual-energy computed tomography in analysis strategy for urinary mixed stone

The aim of this study was to characterize and explore the mixed urinary stones by using Dual-Source Dual-Energy Computed Tomography (DSDECT) in vitro. Study scanned 134 human pure and mixed stones that were embedded into fresh porcine kidneys. Image analysis of these stones gave us the mean attenuation values in Hounsfield units (HU) and dual-energy index (DEI) at 80 kVp and 140 kVp. The mean of attenuation values, dual-energy and DEI were statistically different between uric acid (UA) containing and other stones, including mixed stones. For mixed stone, COX/UA and COX/PH had significantly difference in DEI (P<0.05), and the HU of 80 kVp, 140 kVp, and dual-energy were significantly different among COX/PH and PH/UA groups. The 80 kVp HU, 140 kVp HU and dual energy HU were significantly higher in COX/PH group compared with PH/UA group (1316.31 vs 813.23, 717.60 vs 440.03, 951.49 vs 557.38, respectively). The value of 80 kVp HU, 140 kVp HU and dual energy HU in COX/UA was 1052.54, 704.12, 802.94 respectively. DSDECT was precise in the differentiation of UA-containing stones and gave promising results for mixed stones of different types.