Contrast Substance Research Articles

Coronarographic and magnetic-resonant study of the myocardium of rats for artificial hypobyosis

The one of newest future methods of anesthesia is the state of artificial hypobiosis. For detail studying this method with a possibility of its further introduction in clinical practice, and before – in conducting clinical studies, it is necessary to have specified data of pre-clinical studies. Among important methods that characterize the completeness of pre-clinical data are magnetic resonance imaging procedure and coronography of key vessels of the myocardium of rats. Coronography – is the rontgenological method of research that demonstrates the structural deformation and speed of the bloodstream of key vessels of the heart. Its principle is based on introducing a contrast substance including iodine in the peripheral vein of a patient with the further rontgenological scanning during several full cycles of circuit. In its turn, the magnetic-resonance imaging procedure of the myocardium – non-invasive method of the structural-diagnostic study characterizes 3D-model using the three-dimensional reconstruction of the cardiac muscle, and also demonstrates the volume of cardiac chambers, characterizing the dynamics of changes of the wall thickness. That is why just these methods were chosen for the detail characteristics of structural-functional changes of the myocardium of rats at artificial hypobiosis. In experiments there were used white outbred male-rats with mass 180-200 g, kept in standard vivarium conditions. The animals were divided in groups: control (intact animals) and experimental (artificial hypobiosis). The number of animals in each group n = 7. Experiments were conducted in correspondence of requirements of the “European convention about protection of vertebral animals, used for experimental and other scientific purpose” (Strasburg, France, 1985), According to general ethical principles of experiments, accepted by the first national congress of Ukraine on bioethics (2001). As a result of the conducted studies, it was demonstrated that the state of artificial hypobiosis favors the essential narrowing of the clearance of great vessels of the myocardium of rats, decrease of the frequency of heart contractions in six times comparing with the control one, and also decrease of the chambers of the cardiac muscle

Atlanto-occipital Approach for Cervical Myelography in Horse with Spinal Cord Compression

The aim of this study was to establish a specific interdisciplinary protocol for evaluation of horses with spinal cord compression. A filly was presented with signs of ataxia at the Faculty of Veterinary Medicine Cluj-Napoca. After neurological examination the presumptive diagnostic was spinal cord compression. Under general anesthesia, the patient was placed for radiological examination in lateral recumbency with head elevated. After antisepsia of cervical region, a Tuohy needle was inserted in atlanto-occipital space and contrast substance was administrated. Radiographic images of the cervical vertebral column were obtained in the neutral, flexed, and extended head positions. The anesthesia protocol was effective, the needle was placed safely in the subarachnoid space and the contrast substance flowed caudally. The obtained radiographic images confirmed spinal cord compressions at the level of cervical vertebrae C3, C4, C5. This working protocol was effective to obtain radiographical images with contrast substance in horses with neurological diseases.

New Device for Endoscopic Vacuum-Assisted Closure (E-Vac) in Acute Mediastinitis from Esophageal Perforation

Acute mediastinitisis an uncommon but potentially devastating infection involving the structures of the mediastinum. The 2 most common causes of acute mediastinitis are esophageal perforation or median sternotomy. Conventional forms of treatment for acute mediastinitisusually involve surgical revision with open dressings or closed irrigation, or reconstruction with vascularized soft tissue flaps such as omentum or pectoral muscle. Vacuum-assisted closure is a treatment with a wound-healing technique based on the application of local negative pressure to a wound. We present the case of a 73 years old male patient admitted in our clinic with esophageal perforation that appeared possible after a endoscopic dilatation done for a esophageal stenosis in the inferior 1/3 part. Using a modified double-lumen naso-gastrig probe adapted to the negative pressure unit and using the same principle as in the negative pressure treatment of soft tissue wounds we have achieved positive results with successful cure of esophageal perforation. The toraco-abdominal Computer Tomography done with contrast substance confirmed the esophageal perforation, acute mediastinitis and bilateral pleuresia. The patient had a full recovery after 29 days of hospitalization with a positive check-up at one and two months after leaving our clinic.

Imaging Diagnosis of a Shoulder Tumor – Case Presentation

Abstract Introduction. The most common and used molecular imaging techniques used in tumor pathology are the following: optics such as fluoroscopy, bioluminescence, and spectroscopy, radionuclides such as positron emission computed tomography, magnetic resonance with or without contrast substance, ultrasound and computed tomography. Material and method. A 39-year-old male patient accused having a shoulder tumor beginning 6 months before with a slow increase in volume without symptoms, pain, local temperature changes, and neurological phenomena. The clinical examination revealed the presence of an elastic consistency tumor, adherent to the bone but movable in soft adjacent tissues, without spontaneous and palpation pain, and local swelling. There was a slight functional embarrassment in conducting the abduction maneuver, but without limiting the amplitude of the movement. Results. Radiography of the shoulder did not reveal any significant changes. Magnetic resonance imaging of the shoulder and contrast-enhanced magnetic resonance imaging of the shoulder were performed. The evoked changes required a computed tomography of the shoulder. Conclusion. The thorough analysis of the imaging investigations and the clinical, paraclinical, and biological context of the patient will lead to the indication of the treatment and the optimal surgical time.

Giant Cell Tumours of the Tendon Sheath – Particular MRI Aspect

Abstract Giant cell tumor of soft tissue (GCTST) is usually of synovial origin. It affects synovial membrane, serous bursae, and tendinous tunnels. The most common localizations are in the hands and forearms. Anatomopathological, GCTST is considered as being composed of a cellular fibroblastic stroma in which the tumor cells are distributed. This type of tumor is composed of a mononuclear complex and osteoclast-like giant multinucleated cells, similar to those found in the giant cell tumor at the bone level. Histologically, some authors consider that GCTST is a strictly benign tumor, consisting of welldefined multinucleated histiocytes admixed with eosinophils, lymphocytes and scattered spindleshaped cells, or hemosiderin deposits in its structure, and tumor cells do not have mitosis or atypia. Other authors consider that GCTST is a type of low-grade sarcoma; this entity was named “malignant fibrous histiocytoma, giant cell type” due to the histological similarity with malignant fibrous histiocytoma. The case of a female patient, suspected of giant cell tumor of the brachioradialis tendon sheath was presented. The MRI aspect of this tumor is not the typical one. The MRI examination consisted of a series of sequences, with T1 and T2 weighted images, fat suppression sequence, performed in all three planes, axial, sagittal, and coronal. Also, the examination was performed native, after the administration of intravenous contrast substance, when the 3D multiplanar sequences were performed. The final diagnosis was the post-operative anatomopathological examination, which confirmed that it was a giant cell tumor. We present this case for its less frequent localization - forearm, and the interest it might have in surgical treatment.

Iodinated Contrast Media in Pediatric Cardiac Angiography Nephrotoxic risk evaluation

Contrast agents are among the most frequently used drugs in medical practice. The aim of our study was to evaluate the incidence of complications associated with the use of different contrast agents in an angiography lab dedicated to pediatric patients with congenital heart disease. Between June 2015 and December 2017, 166 patients with congenital heart disease were diagnosed and/or treated in the angiography lab. Of these patients, 38 were excluded because they did not require contrast substance administration. As interventional procedures we performed pulmonary valvular dilatation in 17 cases (10.2%), stent implantation in coarctation of the aorta in 9 cases (5.4%), PDA closure in 62 cases (37.3%), atrial septal defect (ASD) closure in 36 patients (including patients without contrast agent�s administration) (21.7%). In the group of 129 patients who received contrast agents, the median age was 5.8 years (range 0.1-19 years) and median weight 22.8 kg (range 2.8-72 kg). Average consumption of contrast media per procedure was 79 ml/procedure (range 5 - 400 mL) and 4.3 mL/kg (range 0.4 - 22.7). We used iomeprol (24%), iohexol (8.5%), iopromide (67.4%). No contrast related complications are reported in this group. In conclusion, the contrast agents we used seem to be safe and are not associated with renal complications.

INTERRELATION OF THE LOCALIZATION OF FOCI OF DEMYELINATION WITH THE SEVERITY OF COGNITIVE IMPAIRMENT IN PATIENTS WITH MULTIPLE SCLEROSIS

Most investigation of the multiple sclerosis are devoted to the study of motor and sensory disorders. However, patients also are worried about cognitive impairment, which manifests in memory impairment, attention and reduced working capacity. The relationship between the severity of cognitive impairment and localization of foci of demyelination in patients with remitting multiple sclerosis had been investigated in the given work. It was examined 39 patients. The examination program included: anamnesis, neurological examination, neuropsychological testing and neuroimaging techniques. The MRI study was carried out on the 0.36 T i-Open Magnetic Resonance Imager with the introduction of the Tomovist contrast substance according to the standard test protocol in T1, T2 with a weighted image and FLAIR. Cognitive functions were studied using the international scale MMSE (Mini-mental state examination). Severity of neurological disorders was assessed by the extended disability score scale EDSS. The mean age was 38,9 ± 10,5 years. Disease duration ranged from 3 to 13 years, the average score according to Expanded Disability Status Scale (EDSS) 4,0 ± 1,86. Patients with remitting course of MS were divided into 2 groups depending on MMSE results: group 1 (without cognitive impairment) - patients with MMSE score 28-30 points, group 2 (pre-cognitive impairment) patients with MMSE score 23-27 points. Signs of cognitive impairment were detected in 61,5% of patients. The most pronounced cognitive impairments were in patients with foci of demyelinization subcortical to the temporal lobes of the brain hemispheres and in the corpus callosum. Cognitive impairment in group of patients with an insignificant degree of disability was noted mainly with localization of foci of demyelination in the corpus callosum.

EOSINOPHILIA AS TRIGGER FACTOR FOR DEEP VEIN THROMBOSIS AND PULMONARY EMBOLIA IN A PACIENT WITH THROMBOPHILIA

Introduction. Pulmonary infiltrate and eosinophilia represent a heterogenous group of diseases causes by extrinsic or intrinsic factors. Extrinsic factors represented by medication or infectious agents (parasites, fungi, mycobacteria) may trigger an eosinophilic immune response. We report the case of a 53 years old male patient with pulmonary infiltrate and eosinophilia secondary to Toxocariasis infection who was diagnosed with deep vein thrombosis and pulmonary embolism one month later from the diagnosis of pneumonia. Further investigations demonstrated a hypercoagulable state. Case presentation. On March 2015 a 53 years old male came to my office because of a very intense pain on the left posterior thorax which increased by deeply breathing. Physical exam was in normal range, but chest computer tomography without contrast done in emergency showed pulmonary infiltrate at the base of the left lung with pleuritic reaction. Blood tests showed white blood cells at the upper range with eosinophilia (21.75%, 2,050/mc) and inflammatory syndrome. Investigations for eosinophilia showed a positive Western blot test for Toxocara canis so the patient began the treatment with Albendazolum 800 mg/day for three weeks with positive response. One month later the patient visited us for a pain on the right calf. The ultrasound Doppler vein confirmed the diagnosis of deep vein thrombosis and the chest Computer Tomography with contrast substance described mild right pulmonary embolism. The patient started the anticoagulant treatment. Thrombophilia tests were done, MTHFR A1298C gene and PAI1 675 were positive. Discussions. Helminthic infections are associated with eosinophilia. Helminths who migrate to the viscera as like as Toxocara canis could produce high eosinophilic response. Our questions was if eosinophilia was responsible for the patient thrombosis or was it only the trigger factor? As two genetic tests for thrombophilia (MTHFR A1298C gene and PAI1 675) were positive we considered deep vein thrombosis and pulmonary embolism in the context of hypercoagulable states. Conclusion. This case highlights the implication of eosinophilia as trigger factor for vein thrombosis and pulmonary embolism.

SURGICAL TACTICS IN IATROGENIC DAMAGES OF ESOPHAGUS CAUSED BY TREATMENT AND DIAGNOSTIC INTERVENTIONS

Aim. To analyze the causes of iatrogenic damages of esophagus, estimate the surgical tactics depending on the type and localization of perforation and terms of hospitalization. Materials and methods. Medical documentation of 89 patients with esophageal damages of various etiology was analyzed. Iatrogenic damages of esophagus were diagnosed in 37 (41,6%) patients. Results. The most frequent cause of esophageal perforation during treatment and diagnostic manipulations was gullet bougienage for cicatrical strictures and cardiospasm. This diagnosis was based on pains, occurring after treatment and diagnostic manipulations, which critically increased after taking liquid or food, appearance of soft tissue emphyzema of the neck and mediastinal emphysema. Presence of contrast substance leakage in roentgenoscopy permitted to determine the localization and size of esophageal defect. During the recent years, in case of diagnostic difficulties or late admission to hospital, computed tomography was used. The terms of starting treatment and complications developed substantially determined its volume and surgical tactics. Accordingly, different medical techniques were undertaken. Conclusions. Along with traditional interventions, stenting, clipping of esophageal wounds and vacuum therapy can be used to treat iatrogenic damages, indications to which need further study.

BALO’S CONCENTRIC SCLEROSIS: CLINICAL CASE ОF REMISSION

Objective. Case report of a rare form of multiple sclerosis, Balo’s concentric sclerosis (BCS). Materials and methods. 66 year old female patient L., admitted with complaints of gait disorder with tendency to fall towards the left side, left upper limb weakness and decreased memory. Neurological examination revealed left sided hemiparesis, and left sided positive Romberg’s test. Contrast brain magnetic resonance imaging (MRI) was performed. Treatment was prescribed as well as dynamic follow up during the course of 1.5 years. Results. Based on complaints, clinical picture and MRI result, patient was diagnosed with an atypical form of multiple sclerosis, Balo’s concentric sclerosis. The main diagnostic method used confirm the diagnosis was contrast brain MRI: Non homogenous circular-form space occupying lesion with dimensions 3.7 × 3.4 × 3.5 cm was visualized in the supraventricular area of right parietal lobe with increased and decreased signals on T2 and T1 weighted images respectively. Following intravenous administration of contrast substance, an increased T1-WI signal is observed along the periphery of the described lesion in the right parietal lobe. MRI conclusion: brain demyelination disease with large foci in the right post-frontal lobe region, typical of Balo’s concentric sclerosis. Following the acute clinical state, cytostatic and immunomodulation therapy was prescribed. MRI dynamic observation revealed decrease in dimensions of the significantly enhanced concentric areas. Follow up demonstrated marked remission. Conclusion. This clinical case is of interest due to the rarity of this disease. The basis of diagnosis in our study was MRI investigation which allows for in vivo diagnosis of this pathology. These observations confirm the fact that timely use of modern methods of treatment can achieve not only stabilization of the patients’ state, but also positive clinical and MRI dynamics.

Evaluation of the Success Rate of Ultrasound-guided Transjugular Liver Biopsy (TJLB) and the Associated Complications.

IntroductionTransjugular liver biopsy (TJLB) is a diagnostic radiological intervention, applied to patients with contraindications to percutaneous or laparoscopic liver biopsy. The aim of this study was to determine the safety, effectiveness, complications, and pathological impact of TJLB.MethodsThis cross-sectional study was conducted on 24 consecutive patients, undergoing TJLB at Imam Reza Hospital, affiliated to Mashhad University of Medical Sciences, from April 2010 to March 2011. The inclusion criteria were coagulopathy, thrombocytopenia, and ascites. TJLB was performed by a radiologist, and a guide wire was inserted in the right jugular vein. Right atrium and middle hepatic vein were catheterized, and then, Cook Quick-Core Biopsy Needle was used by ultrasound guidance. Data analysis was performed by SPSS version 16.ResultsThe sample size included 24 subjects (54% males and 46% females). Success rate of TJLB was reported as 87.5% and the intervention duration was 23.89±9.34 min. No complications were reported in 37.5% of the patients; however, pain in the right upper quadrant (33.3%), leakage of contrast substance into the liver capsule (4.2%), and diffuse abdominal pain (4.2%). In 83% of biopsies, suitable samples were obtained for histopathological diagnosis, and 13% of patients were excluded from the study. According to the results, the mean central port track (CPT) was 6.75 ± 2.95.ConclusionTJLB is a relatively effective and safe procedure for patients with contraindications to percutaneous liver biopsy.

Comparative study of non-ionic contrast agents Optiray 350 and Ultravist 370 in myelography in dogs

Introduction: An essential quality of non-ionic contrast agents is that of containing in their chemical composition, elements with high atomic weight, which determine an increasing absorption of the X-ray beam and this will cause intense radiopacity. The possibilities for radiological exploration with non-ionic contrast agents are very wide. Currently the radiological examination with contrast agent no longer constitutes a risky step in medical diagnosis. Aims: To highlight the importance of using the non-ionic contrast agents Optiray 350 and Ultravist 370 in dog’s myelography and to compare the changes induced in cerebrospinal fluid and blood biochemical constituents by the administration of those non-ionic contrast substances. Materials and Methods: To determine the influence of non-ionic preparations Optiray 350 and Ultravist 370 on cerebrospinal fluid and on some haematological parameters were included in the study a total of 10 dogs. Results: Myelographies with Optiray 350 and Ultravist 370 in dogs with severe spinal condition negatively influence biochemical and haematological blood status, being necessary to take preventive measures. Optiray 350 and Ultravist 370 administration cause a slight sensitization of liver with blood biochemical parameters return to normal within 24-48 hours. Conclusion: Non-ionic contrast agents Optiray 350 and Ultravist 370 offer a very good opacification of the subarachnoidian space, but because it causes liver sensitization, we recommend using them with caution and only after a prior check of liver function.

Coronary Angiography in Isolated Hearts and Its Forensic Application

To check the isolated heart by coronary angiography to discover the location, nature and degree of the coronary artery lesions more accurately and increase the comprehensive evaluation ability of cardiovascular disease. Ten fresh isolated hearts with different causes of death were extracted and injected with barium sulphate as contrast substance by ring injector, then developed under Xper FD20 angiography equipment. The obtained pictures and image data were handled by three-dimensional angiography images with the software attached to the angiography equipment. The coronary artery tissues were HE stained and observed by microscope. The HE staining results were compared with the angiographic results. The imaging data obtained from the 10 cases for examination showed 8 cases without coronary artery stenosis and 2 cases with Ⅲ, Ⅳ coronary artery stenosis, which were consistent with HE staining results of coronary artery organization and the both results were confirmed. Isolated coronary angiography has an unique advantage for accurate grading of classification of coronary artery stenosis, examination of vascular malformation and tiny lesions, which can provide reference for the localization of small lesions and basis during the autopsy for identification conclusion.

The role of contrast-enhanced ultrasound in risk assessment of carotid atheroma

This article illustrates the use of contrast-enhanced ultrasound in the risk assessment of carotid atherosclerotic lesions, especially in challenging plaques evaluation. Materials and methods: For 23 patients with difficult duplex ultrasound examination due to carotid tortuosity or calcifications we assessed plaque morphology (contour, echogenicity and stenosis degree) using contrast substance (Sonovue, Braco) with dedicated vascular low mechanical index CPC software. Conclusion: Contrast-enhanced ultrasound is a new, noninvasive, and safe procedure for imaging carotid atherosclerotic lesions. It is a valuable tool for evaluating the vulnerable plaque at risk for rupture and for the diagnostic of the development and severity of systemic atherosclerotic disease.

Serous cystadenoma of a pancreas: Experience of diagnostics and treatment

Purpose: To analyse the experience of the treatment of patients with pancreatic serous cystadenomas (SCA). Materials and methods: 65 patients (22–77 years) with pancreatic SCA were revealed and treated during 1999–2015. Women prevailed (86,2%). Preoperative inspection: ultrasonography, MSCT and MRI/MRCP. Results: 40,0% of patients didn't have complaints. Complaints were: pain (28,2%), dyspepsia (41,0%), loss of weight (10,2%). Single neoplasms – 63(96,9%), multiple – 2(3,1%). Sizes: from 12,0х9,0 till 72,0 × 58,0 × 57,0 mm. Localization: proximally – 47(72,3%), distally – 17(26,2%), total – 1(1,5%). Radiology criteria of SCA: accurate equal contours; mono-/polycyclic form; liquid structure with existence single (macrocystic – 49(75,4%) or multiple (microcystic – 16(24,6%) partitions; capsule; partition accumulated contrast substance in arterial and venous phases at MSCT/MRI. MRI diagnosed neoplasms more accurately (especially microcystic) and without X-ray loading. 36(73,5%) patients with microcystic neoplasms were operated on. The sizes and localization of macrocystic neoplasms, absence of complaints allowed to leave under supervision without surgical treatment 13(26,5%) patients. Median of supervision – 5,76 ± 3,4 years. Growth of neoplasms wasn't revealed in 9(69,2%) cases. Surgical treatment was carried out at fixing dynamic growth of neoplasm or emergence of complaints. All patients with microcystic neoplasms were operated on. Laparoscopic or robot-assissted equipment preferred at surgical treatment. Recurrence wasn't obtained in any case. Conclusion: Macrocystic SCA prevailed (75,4%) Neoplasms were mainly localized in proximal part of a pancreas (72,3%). MRI is preferable in diagnostics of SCA. Macrocystic SCA can be dynamically observed in the absence of complaints. Microcystic SCA should be subjected surgical treatment.

Anesthetic management of a child undergoing bilateral laparoscopic adrenalectomy

Pheochromocytoma is a rare catecholamine secreting neuroendocrine tumor in children. It is usually localized unilaterally in adults but often bilaterally in children. The symptoms are variable related to the level of secreted catecholamine. The most common symptoms are hypertension, tachycardia and headache. Beta blockers, alcohol consumption, injection of contrast substance and surgical procedures may lead to attacks. The most effective treatment is surgical resection. In recent years, laparoscopic surgery has been more preferred. Anesthetic management is very important in this cases. Especially, sudden hemodynamic changes may be observed during laparoscopic adrenalectomy. In our case, the control of hemodynamic changes with esmolol and norepinephrine infusion were discussed during bilaterally laparoscopic adrenalectomy in a 14-year old child with pheochromocytoma.

Contrast-induced nephropathy (Pharmacology of X-ray contrast agents)

In the last 30 years the use of X-ray contrast media (RCM) has increased significantly during urography, angiography, computed tomography, and operating procedures. Every year the world uses about 60 million doses of PKM, but, despite the use of newer and less nephrotoxic drugs, the risk of contrast-induced nephropathy (CIN) is still significant, especially among patients with prior renal impairment. Contrast induced nephropathy is a major cause of acute renal injury and is a huge problema in clinical practice. So far, con-tradictions remain in the understanding of many aspects of CIN. Contrast-induced nephropathy is acute renal failure (ARF) occurs within 48-72 hours after intravenous administration of contrast sub-stances. Toxicity PKC determined their molecular structure and its ability to dissociate in aqueous solution into ions which consist of salts which dissociate into cations and anions. The contrast-induced nephropathy is manifested in the increase of serum creatinine of 44 mmol/L (0.5 mg / dl) or more and the same rise in serum creatinine of more than 25 % compared to baseline in the absence of other possible causes. ARF is a sudden and sustained reduction in glomerular filtration rate and urine volume, or both together. Thus renal dysfunction existing even more than 1 month can be regarded as acute renal dysfunction. Usually the development of acute renal failure occurs within 1-7 days. The criteria of sustainability is a dysfunction of its registration within 24 hours or more. The aim: to consider different approaches to the pathogenesis, risk factors and achievements in the prevention of contrast-induced nephropathy.

Ultrasound-Guided Thoracic Paravertebral Block Experience in a Child.

Ultrasound-Guided Thoracic Paravertebral Block Experience in a Child.

Functionalized magnetic nanoparticles for biomedical applications.

Functionalized magnetic nanoparticles followed two main directions in the field of biomedical applications: one direction is as image enhancing agents for magnetic resonance imaging (MRI) and the other is as drugdelivery devices for various biologically-active substances. A third field which just emerges in nanomedicine is the field of the so-called theranostic devices which combines in the same delivery vehicle both the therapeutic agent and the contrast substance. The advantages of using nanoparticles instead of larger carriers for delivery of both drug and image contrast enhancing agents will be highlighted throughout this review article. Despite the ever increasing number of articles reporting both in vitro and in vivo studies carried out on functionalized magnetic nanoparticles and envisaging their potential biomedical applications, only few formulations reached the phase of clinical trials and even fewer became marketed products. The perspectives in the field are open, since new drugs require new delivery devices and possibly new means of functionalization. At the same time, the field of nanomedicine also provides the opportunity to better exploit drugs that are already in clinical use by improving their bioavailability through appropriate nanoformulations.

Air-Migration after Ureteral Intervention: A Prospective Case Series

Aims: To investigate whether air in the kidney or bladder is only associated with gas - forming infection, or whether it can be observed after endoscopic interventions including ureteral and cystoscopic. If this is the case, what are the parameters that affect the amount of air in the urinary tract? Study Design: A prospective case series study. Place and Duration of Study: Sample: Department of Urology, Kafkas University Faculty of Medicine, between 2013 and 20 14. Methodology: One hundred and forty patients who underwent any kind of ureteral intervention including flexible ureteroscopic lithotripsy (FURS - L), semi - rigid ureteroscopic lithotripsy (URS - L), double J stenting alone (JJS), URS - L + JJS, and FURS - L + JJ S due to urinary system stones were enrolled. Computed tomography without contrast substance was performed 6 hours after ureteral intervention in order to determine whether there was any air in the urinary tract. Two groups were