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Lee HY et al, 2015: Noncontrast computed tomography factors that predict the renal stone outcome after shock wave lithotripsy.

Lee HY, Yang YH, Lee YL, Shen JT, Jang MY, Shih PM, Wu WJ, Chou YH, Juan YS.
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
Division of Statistical Analysis, Department of Medical Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Urology, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan.
Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
Department of Radiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.

Abstract

OBJECTIVES: Extracorporeal shock wave lithotripsy (ESWL) is a popular treatment for nephrolithiasis. We took advantage of noncontrast abdominal computed tomography (NCCT) to search the possible prognostic factors including abdominal fat distribution influencing stone-free rate.
METHODS: From August 2008 to August 2010, 145 patients who had renal calculus and had undergone ESWL were retrospectively reviewed. All of them received NCCT assessment before ESWL and were followed up after 1 month for stone clearance. These patients were divided into two groups: one was the stone-free group and the other was the residual-stone group. Affecting parameters included stone size, location, stone surface area, Hounsfield unit density (HU density), skin-to-stone distance (SSD), and abdominal fat area as analyzed between these two groups.
RESULTS: Of 145 patients, 70 were stone-free and 75 had residual stone after ESWL treatment and 1-month follow-up. From univariate analysis, stone size, HU density, SSD, and stone surface area were significant predicting factors for ESWL success. On multivariate analysis, the important factors influencing ESWL outcomes were HU density and stone surface area (odds ratio 1.002 vs. 77.18, respectively; P<.05). Abdominal fat accumulation and distribution had no significant difference between these two groups.
CONCLUSION: This study revealed that stone size, HU density, SSD, and stone surface area were associated with stone-free rate after ESWL treatment. Therefore, these factors could be used to assess the feasibility of ESWL before deciding the treatment strategy. Abdominal fat distribution had no significant impact on ESWL outcome for renal stones.

Clin Imaging. 2015 Apr 25. pii: S0899-7071(15)00102-3. doi: 10.1016/j.clinimag.2015.04.010. [Epub ahead of print] 

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Comments 1

Peter Alken on Wednesday, 16 September 2015 10:30

There focus is on fat. But they do not yet have a lot of followers in the literature. I had read and commented a previous publication of these authors on ESWL and the significant effect of abdominal fat accumulation and distribution on the success rate with ureteral stones and wanted to have a look on it again. By clicking on that reference in the present publication I was lead to the Springer portal http://link.springer.com/article/10.1007%2Fs00330-012-2413-6 There is a nice tool I had not seen before: The “Open Relationship Map” to visually explore the content and find related article; unfortunately it works only on Springer publications but it is fun, try it.

There focus is on fat. But they do not yet have a lot of followers in the literature. I had read and commented a previous publication of these authors on ESWL and the significant effect of abdominal fat accumulation and distribution on the success rate with ureteral stones and wanted to have a look on it again. By clicking on that reference in the present publication I was lead to the Springer portal http://link.springer.com/article/10.1007%2Fs00330-012-2413-6 There is a nice tool I had not seen before: The “Open Relationship Map” to visually explore the content and find related article; unfortunately it works only on Springer publications but it is fun, try it.
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