Abstract
BackgroundNephrolithiasis is one of the most common renal pathologies and is routinely encountered in daily practice. Non-contrast computed tomography (NCCT) is the gold standard diagnostic imaging modality for urolithiasis. The role of HU (Hounsfield units) in calculus as a predictor of extracorporeal shock wave lithotripsy (ESWL) has been studied in the past. This study aims to evaluate the role of HU value and various other NCCT indices in predicting the outcome of ESWL.Material and methodsThis was a prospective observational study that included 45 patients suffering from nephrolithiasis who underwent NCCT-KUB (kidney, ureter, and bladder) followed by ESWL. The NCCT indices were evaluated and correlated with the outcome of ESWL. NCCT-KUB was performed using multidetector SIEMENS® SOMATOM EMOTION 16-slice CT scanner (SIEMENS, Munich, Germany).ResultsIn our study, the HU value turned out to be a statistically significant predictor of ESWL success (p <0.05), and the renal pelvis also proved to be a good prognostic indicator for ESWL success. The cut-off value of <1179 HU favored a successful outcome of ESWL, while if >1179 HU, ESWL is likely to fail. Hence, the successful outcome of ESWL is inversely proportional to the HU value. Renal pelvic calculi (n=14) showed a 100% success rate, which was better than all other calculus locations (p<0.05). However, the rest of the indices did not show any statistical significance.ConclusionMulti-detector NCCT-KUB indices can help in the selection of patients with a good prognosis for ESWL, which will prevent the patient from undergoing undesired invasive procedures.
Highlights
Nephrolithiasis is a commonly encountered renal pathology in routine practice [1]
The successful outcome of extracorporeal shock wave lithotripsy (ESWL) is inversely proportional to the HU value
We found that out of all the indices, only the HU value emerged as a statistically significant index for prognosticating the outcome of ESWL
Summary
Nephrolithiasis is a commonly encountered renal pathology in routine practice [1]. The typical clinical presentation is that of flank pain, which can radiate to the groin. This pain is usually severe and colicky [7]. Imaging evaluation of nephrolithiasis includes plain radiography, ultrasound, and computed tomography. Non-contrast computed tomography (NCCT) is the gold standard diagnostic imaging modality for nephrolithiasis, which yields additional information or findings such as hydroureteronephrosis, perinephric collection, fat stranding, and other causes of pain [9,10]. Nephrolithiasis is one of the most common renal pathologies and is routinely encountered in daily practice. Non-contrast computed tomography (NCCT) is the gold standard diagnostic imaging modality for urolithiasis.
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