Assessment of Hounsfield Units and Factors Associated with Fragmentation of Renal Stones by Extracorporeal Shock Wave Lithotripsy: A Computerized Tomography Study

Assessment of Hounsfield Units and Factors Associated with Fragmentation of Renal Stones by Extracorporeal Shock Wave Lithotripsy: A Computerized Tomography Study

The success rate of extracorporeal shock wave lithotripsy (ESWL) is influenced by various factors, including stone density, and is determined through computed tomography scans in terms of Hounsfield units (HU). This retrospective single-center study was conducted in the King Fahad Hospital. Sixty-se...

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Published in:Tomography (Ann Arbor) Vol. 10; no. 1; pp. 90 - 100
Main Authors: Alharbi, Abdallah Saud, Gameraddin, Moawia, Gareeballah, Awadia, Shrwani, Zahra Jibril, Sindi, Moa'ath Abdullah, Alsaedi, Hassan Ibrahim, Qurashi, Abdulaziz A, Aloufi, Khalid M, Alshamrani, Abdullah Fahad A, Alzain, Amel F
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 01-01-2024
MDPI
Subjects:
Adult
Aged
Calcium
Care and treatment
CT imaging
CT number
Diabetes
Diabetes Mellitus
Diabetics
ESWL
fragmentation
Humans
Hypertension
Kidney stones
Lithotripsy
Medical screening
Middle Aged
renal stones
Retrospective Studies
Risk factors
serum calcium
Tomography
Uric Acid
Young Adult
Saudi Arabia
ESWL
CT number
renal stones
uric acid
serum calcium
fragmentation
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Summary:The success rate of extracorporeal shock wave lithotripsy (ESWL) is influenced by various factors, including stone density, and is determined through computed tomography scans in terms of Hounsfield units (HU). This retrospective single-center study was conducted in the King Fahad Hospital. Sixty-seven adult patients with renal and ureteric stones were selected randomly and enrolled in the study. Their ages ranged from 20 to 69 years. The patients were examined with non-contrast enhancement (NCCT) to assess the HU of their stones and were consequently treated with ESWL. Of the 67 patients, 37.3% had stones that were completely fragmented, while 62.7% had stones that were partially fragmented. The HU, location of the stone, multiplicity of the stone, and patient age were found to be significant factors contributing to stone fragility ( -values < 0.05). The HU data were found to have a positive significant linear correlation with serum calcium (r = 0.28, -value = 0.036), while serum acid had a negative correlation (r = -0.55, -value < 0.001). Thus, the probability of calcium-containing stone formation increases with increased HU. In contrast, uric acid stone formation likely develops with decreasing HU with serum uric acid. Renal stones in patients with diabetes mellitus and hypertension were not completely fragmented compared to those without clinical history. Mean HU, location of the stone, laterality, stone status, and the number of ESWL sessions are the most significant factors affecting stone fragility. CT attenuation values can predict the composition of stones from serum calcium and uric acid examinations. Hypertension and diabetes mellitus are risk factors for renal stone fragmentation.
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ISSN:2379-139X
2379-1381
2379-139X
DOI:10.3390/tomography10010008