신석 환자에서 비조영증강 전산화단층촬영술을 이용한 체외충격파쇄석술의 치료효과 예측
Predicting the Therapeutic Effect of Extracorporeal Shockwave Lithotripsy by Non-enhanced Computed Tomography in Renal Stones
김정훈, 문영태,
소속 상세정보
김정훈 ( Kim Jung-Hoon )
중앙대학교 의과대학 비뇨기과학교실
문영태 ( Moon Young-Tae )
중앙대학교 의과대학 비뇨기과학교실
KMID : 0358320080490030252
Abstract
Purpose: To evaluate the value of non-enhanced computed tomography (NECT) as a predictor of renal stone destruction by the use of extracorporeal shock wave lithotripsy(SWL).
Materials and Methods: The study included 34 patients with a renal stone diagnosed by NECT. The stone location and size, body mass index(BMI), Hounsfield units(HU) density, and skin-to-stone distance(SSD) were assessed. The SSD was calculated by averaging three distances from the skin to the stone(at 0o, 45o and 90o angles) on NECT. The HU density was evaluated by measuring three different areas of the stone on NECT. Failure of disintegration was defined as no fragmentation or expulsion of the stone after three sessions of SWL.
Results: Failure of disintegration was observed in 14 patients(41.2%). The mean SSD was 8.70±0.75cm for patients where SWL failed to disintegrate the stone(failure group) versus 6.90±1.19cm for patients where SWL successfully disintegrated the stone(success group)(p＜0.01). The mean BMI of the failure group(26.37±2.29kg/m2) was significantly higher than that of the success group(23.36±3.48kg/m2)(p＜0.01). Stone laterality, size, and HU density were not related to the stone fragmentation rate(p＞0.05). By multivariate analysis, SSD was found to independently decrease the stone fragmentation rate of a renal stone(p=0.013; odds ratio=6.219).
Conclusions: The SSD on NECT and BMI may predict the success of SWL for a renal stone. (Korean J Urol 2008;49:252-256)
키워드
Tomography;Lithotripsy;Urinary calculi
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