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    Korean J Urol. 2006 Jan;47(1):70-74. Korean.
    Published online Jan 31, 2006.
    https://doi.org/10.4111/kju.2006.47.1.70
    Copyright © 2006 The Korean Urological Association
    Original Article

    Hounsfield Units of Urinary Calculi as a Predictor of the Therapeutic Effect of Extracorporeal Shockwave Lithotripsy

    Hyun Soo Chae and Seong Ho Lee
      • Department of Urology, College of Medicine, Hallym University, Chuncheon, Korea.
    • Corresponding author (Email: shleeuro@hallym.ac.kr )
    Received June 13, 2005; Accepted October 17, 2005.

    Abstract

    Purpose

    Non-enhanced spiral computed tomography (NESCT) has become the preferred method for imaging urinary calculi. We evaluated the Hounsfield units (HU) of urinary calculi on NESCT as a predictor of the therapeutic effect of extracorporeal shockwave lithotripsy (ESWL).

    Materials and Methods

    We evaluated 72 patients with urinary calculi who underwent ESWL. The HUs of calculi were measured on the pretreatment NESCT and at post-treatment via radiographic assessment. The patients were divided into 2 groups, the response group (n=39): the patients with remnant calculi less than 3mm or they were without remnant calculi, and the non-response group (n=33): the patients with remnant calculi greater than 3mm. The HUs of the response and non-response groups were then compared.

    Results

    The HUs of the response and non-response groups were 529.7±168.2 and 814±116.6, respectively, and the HUs of the non-response group was significantly higher than that of the non-response group.

    Conclusions

    The HU of urinary calculi, as seen on NESCT, can help to predict the therapeutic effect of ESWL and also select the most effective treatment modalities for the patients suffering with urinary calculi.

    Keywords
    Urinary calculi; Tomography; Lithotripsy

    Figures

    Fig. 1
    (A) One calculus is demonstrated in right upper ureter. (B) The mean Hounsfield unit (HU) values in the selected area is measured.

    Tables

    Table 1
    Comparison of Hounsfield units (HUs) in both groups according to the stone size

    References

      1. Sierakowski R, Finlayson B, Landes RR, Finlayson CD, Sierakowski N. The frequency of urolithiasis in hospital discharge diagnoses in the United States. Invest Urol 1978;15:438–441.
      1. Leusmann DB, Niggemann H, Roth S, von Ahlen H. Recurrence rates and severity of urinary calculi. Scand J Urol Nephrol 1995;29:279–283.
      1. Ahn SS, Lee SH, Kang IM. The value of non-enhanced spiral CT in the diagnosis of suspected urolithiasis. Korean J Urol 2002;43:1008–1013.
      1. Smith RC, Verga M, McCarthy S, Rosenfield AT. Diagnosis of acute flank pain: value of unenhanced helical CT. AJR Am J Roentgenol 1996;166:97–101.
      1. Smith RC, Verga M, Dalrymple N, McCarthy S, Rosenfield AT. Acute ureteral obstruction: value of secondary signs of helical unenhanced CT. AJR Am J Roentgenol 1996;167:1109–1113.
      1. Levine JA, Neitlich J, Verga M, Dalrymple N, Smith RC. Ureteral calculi in patients with flank pain: correlation of plain radiography with unenhanced helical CT. Radiology 1997;204:27–31.
      1. Olcott EW, Sommer FG, Napel S. Accuracy of detection and measurement of renal calculi: in vitro comparison of three-dimensional spiral CT, radiography, and nephrotomography. Radiology 1997;204:19–25.
      1. Narepalem N, Sundaram CP, Boridy IC, Yan Y, Heiken JP, Clayman RV. Comparison of helical computerized tomography and plain radiography for estimating urinary stone size. J Urol 2002;167:1235–1238.
      1. Mostafavi MR, Ernst RD, Saltzman B. Accurate determination of chemical composition of urinary calculi by spiral computerized tomography. J Urol 1998;159:673–675.
      1. Nakada SY, Hoff DG, Attai S, Heisey D, Blankenbaker D, Pozniak M. Determination of stone composition by noncontrast spiral computed tomography in the clinical setting. Urology 2000;55:816–819.
      1. Saw KC, McAteer JA, Fineberg NS, Monga AG, Chua GT, Lingeman JE, et al. Calcium stone fragility is predicted by helical CT attenuation values. J Endourol 2000;14:471–474.
      1. Chaussy C, Schuller J, Schmiedt E, Brandl H, Jocham D, Liedl B. Extracorporeal shock-wave lithotripsy (ESWL) for treatment of urolithiasis. Urology 1984;23:59–66.
      1. Singal RK, Denstedt JD. Contemporary management of ureteral stones. Urol Clin North Am 1997;24:59–70.
      1. Politis G, Griffith DP. ESWL. Stone-free efficacy based upon stone size and location. World J Urol 1987;5:225–228.
      1. Mattelaer P, Schroder T, Fischer N, Jakse G. In situ extracorporeal shockwave lithotripsy of distal ureteral stones: parameters for therapeutic success. Urol Int 1994;53:87–91.
      1. Bon D, Dore B, Irani J, Marroncle M, Aubert J. Radiographic prognostic criteria for extracorporeal shock-wave lithotripsy: a study of 485 patients. Urology 1996;48:556–560.
      1. Federle MP, McAninch JW, Kaiser JA, Goodman PC, Roberts J, Mall JC. Computed tomography of urinary calculi. AJR Am J Roentgenol 1981;136:255–258.
      1. Joseph P, Mandal AK, Singh SK, Mandal P, Sankhwar SN, Sharma SK. Computerized tomography attenuation value of renal calculus: Can it predict successful fragmentation of the calculus by extracorporeal shock wave lithotripsy? A preliminary study. J Urol 2002;167:1968–1971.
      1. Gupta NP, Ansari MS, Kesarvani P, Kapoor A, Mukhopadhyay S. Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. BJU Int 2005;95:1285–1288.
      1. Pareek G, Armenakas NA, Panagopoulos G, Bruno JJ, Fracchia JA. Extracorporeal shock wave lithotripsy success based on body mass index and Hounsfield units. Urology 2005;65:33–36.
      1. Byeon SS, Jeon SS, Lee HW, Park EC, Lee JH, Kwak C, et al. Ureteroscopic manipulation for ureteral calculi: comparison with ESWL. Korean J Urol 1996;37:1124–1131.
      1. Erturk E, Herrman E, Cockett AT. Extracorporeal shock wave lithotripsy for distal ureteral stones. J Urol 1993;149:1425–1426.
      1. Kim SS, Sung BM, Ahn SH. Comparison of shock wave lithotripsy (SWL) and rigid ureteroscopic stone removal (URS) for treatment of upper ureteral stones. Korean J Urol 2004;45:444–448.
      1. Dretler SP, Spencer BA. CT and stone fragility. J Endourol 2001;15:31–36.
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    MeSH Terms
    Calculi
    Humans
    Lithotripsy*
    Tomography, Spiral Computed
    Urinary Calculi*
    Metrics
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