Dual-energy computed tomography: A reliable and established tool for In vivo differentiation of uric acid from nonuric acid renal Stones

Abstract

DECT using the 3 generation CT scanners is highly sensitive in the determination of urinary calculi composition which will be very helpful to the treating surgeon in selecting the optimal modality of treatment as UA stones are amenable to medical therapy while most of the non-UA stones require surgical intervention.

Role of Dual-Energy Computed Tomography in Characterization of Ureteric Calculi and Urinary Obstruction

“…In the present study, the proportion of hydroxyapatite and oxalic acid stones together was 53% followed by uric acid (23%) and cysteine (15%), respectively. As far as differentiation between uric acid and non-uric acid stones is concerned, the present study is in concordance with the observations of Ilyas et al who found 85% of their sample to be non-uric acid and only 15% to be uric acid stones [9]. The reason for the difference in the chemical composition of stones in different studies could be attributable to the inclusion criteria used and the difference in dietary habits and ethnicity of the affected population.…”

“…Compared to the present study, Erdogan et al in their study found oxalic acid (42.9%) and hydroxyapatite (36.5%) as the dominant types on DECT while the in vitro analysis showed 22.9% as hydroxyapatite and 51.4% as oxalic acid calculi [15]. In another study, Ilyas et al found oxalic acid as the dominant type seen in 78.4% of their cases [9]. Manglaviti et al in their study did not diagnose hydroxyapatite in any of the cases and reported a dominance of oxalic acid (67.3%) calculi [16].…”

“…The sample size was estimated based on the study by Ilyas M et al who observed the sensitivity and specificity of DECT in differentiating a calcium oxalate from non-calcium oxalate calculus was 97.8% and 92.3%, respectively [9]. Taking these values as a reference, the minimum required sample size with the desired precision of 10%, 80% power of study, and 5% level of significance was 72 patients.…”

“…The ratio of low-and high-energy attenuation was calculated (the DE ratio). Image acquisition and post-processing image interpretation were done per the technique described by Ilyas et al [9]. For uric acid, cysteine, mixed, calcium oxalate, and hydroxyapatite calculi, the cut-off values of the DE ratio were taken as <1.13, 1.13-1.23, 1.23-1.33, 1.33-1.53, and >1.53, respectively, and, accordingly, the chemical composition of the calculi was determined [9].…”

The use of herbal drug Canephron® N in ambulatory meta-prevention of uratolysis

“…несмотря на прогресс в диагностике МкБ, обусловленный использованием различных видов компьютерной томографии, появлением современных эндоскопических, малоинвазивных методов лечения без применения вторичной профилактики, риск рецидива камнеобразования составляет 50% в период от 5 до 10 лет с первых признаков проявления заболевания [12][13][14]. следует признать, что МкБ является мультидисциплинарной проблемой, решением которой занимается широкий круг специалистов: урологи, нефрологи, педиатры, детские урологи и нефрологи, семейные врачи, врачи ультразвуковой и лучевой диагностики.…”