Determination of Renal Stone Composition with Dual Energy CT: In Vivo Analysis and Comparison with Renal Stone Biochemistry
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Background and Objectives: The lifetime prevalence of urinary tract stone has been estimated to be 10-14%.The morbidity associated with urolithiasis includes colic pain and kidney obstruction, which can lead to renal failure and severe urinary tract infections such as pyonephrosis and septic shock in some patients . Dual –energy CT ,by facilitating low and high –energy scanning during a single acquisition, has inherent capability to help differentiate different materials that have similar electron densities but varying photon absorption .Our aim in this study was to preoperatively assess the composition of urinary tract stones with dual energy CT by using postoperative in vitro renal stone biochemistry analysis as the reference standard. Methods: This study was conducted in a group of 50 patients, Patients who are referred for DECT KUB and who are diagnosed to have Renal stone pathology were included in the study. DECT was performed by Somatom definition 128 slice dual energy CT. Result And Conclusion: After DECT finding total 18 patients were detected with calcium hydroxyapatite (CAH) stone. After the stone extraction process, biochemical analysis showed that among these 18 patients all have pure calcium hydroxyapatite as the stone components. This finding matches 100% with the DECT finding. 36% of the total patients have pure calcium hydroxyapatite stone as observed in this analysis. In the table % within DECT finding showed 100% meaning DECT was able to detect all the CAH stones successfully. Similarly, after DECT examination total 10 (20%) patients showed stone composed of pure calcium oxalate. on biochemical analysis, it was observed that among these patients 9(18%) patients have stones composed of pure calcium oxalate (CAO) and 1(10%) patient had calcium hydroxyapatite as the stone component. In this case, DECT was able to find out the stone composition accurately in 90% of cases. Total 3 (6%) patients were detected with uric acid stones after DECT examination. In the biochemical analysis, all of these patients showed the similar result as the DECT examination. Among the total 50 patients, 19 patients showed the presence of a mixed type of stones. In DECT scanning 15 (30%) patients were detected with stones composed of mixed type with calcium hydroxyapatite and calcium oxalate (CAH+CAO). On biochemical finding, a similar number of the patient were detected with calcium oxalate and calcium hydroxyapatite stones (CAH+CAO). Total 4 (8%) patients were detected with calcium oxalate and uric acid mixed stones. In the biochemical analysis, a similar number of patients showed the presence of calcium oxalate and uric acid stones. DECT has effectively identified the composition of calcium hydroxyapatite stones wherein calcium oxalate stones one patient was wrongly identified by DECT. Overall, DECT showed higher accuracy in determining the renal stone composition and very useful in patients with renal stone to decide precise choice of treatment.
Authors and Affiliations
Dr Abdul Wahab Abdulla Mohammed
Keywords
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- EP ID EP572482
- DOI 10.9790/0853-1804060135.
- Views 41
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