Relationship between stone composition detected by preoperative CT plain scan and the therapeutic effect of percutaneous nephrolithotomy(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2018年第10期
- Page:
- 1155-1159
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Relationship between stone composition detected by preoperative CT plain scan and the therapeutic effect of percutaneous nephrolithotomy
- Author(s):
- LIU Hailong; XIE Ting; HUANG Peikai; LIU Tianzhu
- Department of Imaging, Zhuhai Hospital, Traditional Chinese Medicine Hospital of Guangdong Province, Zhuhai 519000, China
- Keywords:
- ; Keywords: computed tomography plain scan; stone composition; renal stone; percutaneous nephrolithotomy
- PACS:
- R692.4
- DOI:
- DOI:10.3969/j.issn.1005-202X.2018.10.008
- Abstract:
- Abstract: Objective To analyze the relationship between stone composition detected by preoperative CT plain scan and renal stone removal by percutaneous nephrolithotomy (PCNL). Methods From January 2016 to January 2018, 310 patients with renal stones who underwent PCNL in Zhuhai Hospital, Traditional Chinese Medicine Hospital of Guangdong Province were enrolled in this study. The stones were divided into the treatable group (208 cases) and refractory group (102 cases) according to the stone composition detected by preoperative CT plain scan. The stone-free rates in different groups were compared. The consistency between the preoperative CT judgment and the stone-free rate after operation was analyzed. Results Of 310 patients with renal stones, 288 cases (92.90%) achieve renal stone removal, including 28 cases (9.72%) with calcium oxalate monohydrate stones, 48 (16.67%) with calcium phosphate stones, 91 (31.60%) with calcium oxalate dihydrate stones, 70 (24.31%) with magnesium ammonium phosphate stones, and 51 (17.70%) with uric acid stones. The stones in the other 22 cases were not removed (7.10%), including calcium oxalate monohydrate stones in 7 cases (31.82%), calcium phosphate stones in 9 cases (40.91%), calcium oxalate dihydrate stones in 3 cases (13.64%), magnesium ammonium phosphate stones in 2 cases (9.09%), and uric acid stones in 1 case (4.54%). The operation time of treatable group was significantly shorter than that of refractory group (P<0.05), and the intraoperative blood loss and CT value of treatable group were significantly lower than those of refractory group (P<0.05). No statistical significance was found in hospital stay between two groups (P>0.05). According to the outcomes of PCNL, the patients were divided into stone group in which the stones were not removed and stone-free group in which the stones were removed. Compared with stone group, stone-free group had significantly shorter operation time (P<0.05), and obviously decreased intraoperative blood loss and CT value (P<0.05), and there were no statistical differences in hospital stay between two groups (P>0.05). The consistency between the preoperative CT judgment and the stone-free rate after operation was confirmed. The sensitivity, specificity, and accuracy of preoperative CT judgment for stone removal were 71.53%, 90.91% and 72.22%, respectively. The positive and negative predictive values of preoperative CT judgment were 99.04% and 19.61%, respectively, and the Kappa value was 0.73. Conclusion Preoperative CT plain scan which has certain predictive value for the therapeutic effect of PCNL should be paid enough attention in clinic.
Last Update: 2018-10-22