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28.01.2020 | Original Paper | Ausgabe 6/2020

Urolithiasis 6/2020

Three-dimensional mean stone density on non-contrast computed tomography can predict ureteroscopic lithotripsy outcome in ureteral stone cases

Zeitschrift:
Urolithiasis > Ausgabe 6/2020
Autoren:
Shimpei Yamashita, Yuya Iwahashi, Ryusuke Deguchi, Kazuro Kikkawa, Yasuo Kohjimoto, Isao Hara
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Abstract

The association between mean stone density (MSD) and ureteroscopic lithotripsy outcome remains controversial. MSD automatically measured by 3D images of stones (3D-MSD) was recently reported to be more useful than manual measuring methods for predicting outcomes of shock-wave lithotripsy. This study aims to investigate whether 3D-MSD can predict ureteroscopic lithotripsy outcome. We retrospectively identified 218 patients who underwent ureteroscopic lithotripsy for kidney stones (n = 135) and ureteral stones (n = 83) between February 2011 and April 2017 with pretreatment non-contrast computed tomography (NCCT) at our hospital. Stone volume and 3D-MSD were automatically measured using high functional viewer. Logistic regression analysis was performed to identify factors contributing to treatment failure. Treatment failure was determined as residual fragments ≥ 4 mm using NCCT within 3 months after operation. Treatment failure rate was 20.1% (44/218 cases). Patients in treatment failure group had higher percentage of kidney stones (< 0.01) and multiple stones (p < 0.01), larger stone volume (p < 0.01) and higher 3D-MSD (p < 0.01). Multivariate analysis revealed that stone location (p < 0.01), stone number (p < 0.01), stone volume (p = 0.02) and 3D-MSD (p = 0.02) independently predicted the outcome. Categorized by stone location, 3D-MSD was the only significant independent predictor in cases of ureteral stones (p < 0.01), but was not significant in cases of kidney stones. 3D-MSD is useful for predicting ureteroscopic lithotripsy outcome in cases of ureteral stones.

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