MP7-02 PRE-OPERATIVE FAT DENSITY CHARACTERISTICS FROM COMPUTED TOMOGRAPHY IMAGING IS PREDICTIVE OF EASE OF PERINEPHRIC FAT DISSECTION AT TIME OF PARTIAL NEPHRECTOMY

Abstract

INTRODUCTION AND OBJECTIVES: To determine whether renal papillae density using attenuation measurement (HU) on noncontrast Computed Tomography (CT) can predict the development of urinary calculi in stone free patients as well in recurrent stone formers and its role in predicting any associated urinary metabolic abnormality. METHODS: In this study we compared renal papillae density using attenuation measurement (HU) on noncontrast Computed Tomography (CT) in stone forming group (SFG) (first time stone formers and recurrent stone formers) with the healthy stone free control group (CG). The SFG inclusion criteria were active stone disease (unilateral or bilateral) diagnosed by abdominal computed tomography. Prospective living kidney donor without active or past history of stone disease formed CG. Papillae tip attenuation was measured using noncontrast CT. Mean Hounsfield density (HU) of 3 caliceal group was calculated for each kidney. 24 hours urinary metabolic evaluation was done wherever deemed necessary. Statistical analysis was done using student’s ttest. RESULTS: Total of 665 SFG and 104 CG patients met inclusion criteria. 343 patients had bilateral urolithiasis, 312 patients had unilateral urolithiasis, 52 were recurrent stone former and 38 patients having hyperoxaluria and hypercalciuria each. Mean HU of papillae of SFG was greater than that of CG (29.46 3.06 Vs 27.71 0.48; p 0.05) as was patients having Hyperoxaluria (29.80 2.15 Vs 29.46 3.06, p>0.05). CONCLUSIONS: Mean HU of renal papillae was significantly increased in patient with urolithiasis. This holds valid for papillae with or without calculi. There isnosignificant differencebetweenmeanHUof renal papillae density in patients having Hypercalciuria/Hyperoxaluria when compared with stone bearing patients with normal urinarymetabolic study.