Can stone density on plain radiography predict the outcome of extracorporeal shockwave lithotripsy for ureteral stones?
임기홍, 정진희, 권재현, 이용석, 배정범, 조민철, 이광수, 이해원,
소속 상세정보
임기홍 ( Lim Ki-Hong )
Dongguk University Ilsan Hospital Department of Urology
정진희 ( Jung Jin-Hee )
Dongguk University Ilsan Hospital Department of Radiology
권재현 ( Kwon Jae-Hyun )
Dongguk University Ilsan Hospital Department of Radiology
이용석 ( Lee Yong-Seok )
Dongguk University Ilsan Hospital Department of Radiology
배정범 ( Bae Jung-Bum )
Dongguk University Ilsan Hospital Department of Urology
조민철 ( Cho Min-Chul )
Dongguk University Ilsan Hospital Department of Urology
이광수 ( Lee Kwang-Soo )
Dongguk University Ilsan Hospital Department of Urology
이해원 ( Lee Hae-Won )
Dongguk University Ilsan Hospital Department of Urology
KMID : 0358320150560010056
Abstract
Purpose: The objective was to determine whether stone density on plain radiography (kidney-ureter-bladder, KUB) could predict the outcome of extracorporeal shockwave lithotripsy (ESWL) for ureteral stones.
Materials and Methods: A total of 223 patients treated by ESWL for radio-opaque ureteral stones of 5 to 20 mm were included in this retrospective study. All patients underwent routine blood and urine analyses, plain radiography (KUB), and noncontrast computed tomography (NCCT) before ESWL. Demographic, stone, and radiological characteristics on KUB and NCCT were analyzed. The patients were categorized into two groups: lower-density (LD) group (radiodensity less than or equal to that of the 12th rib, n=163) and higher-density (HD) group (radiodensity greater than that of the 12th rib, n=60). Stone-free status was assessed by KUB every week after ESWL. A successful outcome was defined as stone free within 1 month after ESWL.
Results: Mean stone size in the LD group was significantly smaller than that in the HD group (7.5±1.4 mm compared with 9.9±2.9 mm, p=0.002). The overall success rates in the LD and HD groups were 82.1% and 60.0%, respectively (p=0.007). The mean duration of stone-free status and average number of SWL sessions required for success in the two groups were 21.7 compared with 39.2 days and 1.8 compared with 2.3, respectively (p<0.05). On multivariate logistic analysis, stone size and time to ESWL since colic and radiodensity of the stone on KUB were independent predictors of successful ESWL.
Conclusions: Our data suggest that larger stone size, longer time to ESWL, and ureteral stones with a radiodensity greater than that of the 12th rib may be at a relatively higher risk of ESWL failure 1 month after the procedure.
키워드
Bone density; Lithotripsy; Ureteral calculi
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