SIGNIFICANCE OF HOUNSFIELD UNITS ON NON-CONTRAST COMPUTED TOMOGRAPHY IN DETERMINING STONE FREE RATE AFTER ESWL

Salman Arshad, Khalid Mahmood, Abdul Khalique, Pardeep Kumar, Muhammad Mubarak, Manzoor Hussain, Syed Adeeb-ul-Hassan Rizvi

Abstract


ABSTRACT                                            

Objective: To determine the frequency of stone-free rate after extracorporeal shockwave lithotripsy (ESWL) and its relationship with Hounsfield Units (HUs) of renal calculi.

Methodology:  This observational study was carried out at the Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan, from June 2015 to December 2015. All patients were evaluated for serum creatinine, coagulation profile, urinalysis and culture and imaging studies including non-contrast computed tomography (NCCT). All were evaluated with x-ray and ultrasound KUB at six weeks of ESWL session. Patients with residual fragments more than 4 mm in size were offered another session of ESWL. In case of persistent stone fragments more than 4 mm in size, stones were labeled as ESWL-refractory and alternative treatment options offered.

Results: A total of 139 patients were included in this study. The mean age was 40.0 ± 8.9 years and 91 (65.47%) were males. The mean stone size and mean HUs of all patients were 12.7 ± 3.6 mm and 616.9 ± 304.3, respectively. On last follow-up, out of 139, 95 (68.3%) patients were in stone-free group and 44 (31.6%) in residual stone group, with a mean HUs value of 565 ± 62.1 and 905 ± 61.7, respectively (p=0.001). The mean HUs of stone-free group was significantly lower than that of residual stone group.

Conclusion:   Our findings suggest that the HU measurement of renal calculi on pretreatment NCCT might be helpful in predicting stone-free rate after ESWL. 

Key Words: Renal stones, Extracorporeal shockwave lithotripsy, Hounsfield units


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References


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