Dual-Energy Multidetector Computed Tomography: A Highly Accurate Non-Invasive Tool for in Vivo Determination of Chemical Composition of Renal Calculi

التفاصيل البيبلوغرافية
العنوان: Dual-Energy Multidetector Computed Tomography: A Highly Accurate Non-Invasive Tool for in Vivo Determination of Chemical Composition of Renal Calculi
المؤلفون: Mohammad Masood, Sajjad Ahmad Dar, Shafqat Shabir Bhawani, Majid Jehangir, Sajad Nazir Syed
المصدر: Galician Medical Journal; Vol. 28 No. 3 (2021); E202134
Galician Medical Journal; Том 28 № 3 (2021); E202134
Galician Medical Journal, Vol 28, Iss 3, Pp E202134-E202134 (2021)
بيانات النشر: Ivano-Frankivsk National Medical University, 2021.
سنة النشر: 2021
مصطلحات موضوعية: dual-energy ratio, Calcium oxalate, peak kilovoltage, Dual-Energy Computed Tomography, dual-energy computed tomography, Hounsfield Unit, urologic and male genital diseases, Oxalate, Calculi, hounsfield unit, chemistry.chemical_compound, uric acid, In vivo, Hounsfield scale, calculi, Multidetector computed tomography, Medicine, Dual-Energy Ratio, Calculus (medicine), business.industry, medicine.disease, Uric Acid, chemistry, composition, Peak Kilovoltage, Uric acid, Nuclear medicine, business, Composition
الوصف: Introduction. Computed tomography is more accurate than excretory urography in evaluation of renal stones due to its high sensitivity and temporal resolution; it permits sub-millimetric evaluation of the size and site of calculi but cannot evaluate their chemical composition. Dual-energy computed tomography allows evaluating the chemical composition of urinary calculi using simultaneous image acquisition at two different energy levels. The objective of the research was to determine renal stone composition using dual-energy multidetector computed tomography, and its correlation with post-extraction chemical analysis of stones. Materials and Methods. This prospective study was conducted in the Department of Radiodiagnosis and Imaging from September 2017 to March 2019. A total of 50 patients with urolithiasis at the age of 18-70 years were included in the study. Dual-energy computed tomography ratios of various stones were noted, and preoperative composition of calculi was given based on their colour and dual-energy computed tomography ratio. These results were compared with the post-extraction chemical analysis of stones (using Fourier infrared transform spectroscopy as the standard comparative method.) Results. The most common type of calculi in our study population was calcium oxalate stones (78%) followed by uric acid stones (12%), cystine stones (6%) and hydroxyapatite stones (4%). The dual-energy ratio of calcium oxalate, uric acid, cystine and hydroxyapatite stones ranged from 1.38-1.59, 0.94-1.08, and 1.20-1.28 and 1.52-1.57, respectively, with the mean dual-energy ratio of 1.43, 1.01, 1.25 and 1.55, respectively. Dual-energy computed tomography was found to be 100% sensitive and specific for differentiating uric acid stones from non‑uric acid stones. The sensitivity and specificity in differentiating calcium oxalate calculus from non‑calcium oxalate calculus was 97.5% and 90.9%, respectively, with 96% accuracy and kappa value of 0.883 suggesting strong agreement. Conclusions. Dual-energy computed tomography is highly sensitive and accurate in distinguishing between various types of renal calculi. It has vital role in management as uric acid calculi are amenable to drug treatment, while most of non-uric acid calculi require surgical intervention.
وصف الملف: application/pdf; text/xml; text/html
اللغة: English
تدمد: 2414-1518
DOI: 10.21802/gmj.2021.3
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9719aa8362662b68d3773c079ecb5940Test
https://ifnmujournal.com/gmj/article/view/E202134Test
حقوق: OPEN
رقم الانضمام: edsair.doi.dedup.....9719aa8362662b68d3773c079ecb5940
قاعدة البيانات: OpenAIRE
الوصف
تدمد:24141518
DOI:10.21802/gmj.2021.3