Role of Computed Tomography in Differentiation of Radio-Lucent Stones from Radio-Opaque Stones in The Renal System Depending on Attenuation Measurements (Hounsfield Unit)

Authors

  • Dr. Sudad Razoqqi Flayyih M.B.Ch.B., D.M.R.D.\ (Radiology) Iraqi Ministry of Health, Medical City Complex, Baghdad Teaching Hospital, Baghdad, Iraq
  • Dr. Fahad Khalid Radhi M.B.Ch.B., F.I.C.M.S. \ (Urology) Iraqi Ministry of Health, Basrah Health Directorate, Basrah Teaching Hospital, Basrah, Iraq
  • Dr. Ibrahim Mahjar Tuama M.B.Ch.B., C.A.B.M.S. \ (Urology) Iraqi Ministry of Health, Basrah Health Directorate, Basrah Teaching Hospital, Basrah, Iraq

DOI:

https://doi.org/10.51699/ijhsms.v3i1.3279

Keywords:

Radio-Opaque stone, Radio-Lucent stone

Abstract

Renal calculus remains to be a common problem in the hospital. It is the third most common urological problem after urinary tract infection and prostate disease

Computed tomography (CT) has a superior sensitivity and specificity over all other modalities in

Diagnosis of renal stones in determining the size and number of kidney stones, no matter how small it is, also it helps in the identification of Hounsfield unit (HU) and thus determines the composition of gravel.

Aim:

The aim of this study is to differentiate between radio-opaque from radio lucent stones depending on attenuation measurements of the Hounsfield unit (HU) and to find the cutoff value depending on the Hounsfield unit in computed tomography (CT).

PATIENT AND METHOD:

This was a cross-sectional study of 100 patients (65 male and 35 female) aged between 18 and 80, having kidney stones of size more than or equal (l0 mm). The study was done between September 2014 and June 2015 in Al-Emammain Al-Kadhymain Medical City, Baghdad, Iraq. In all patients, an X-ray of the Kidney, ureter, and bladder (KUB) was done after preparation, and then nou contrast Computed Tomography (CT) was performed to all patients. Two parameters were studied, which are the appearance of stone on KUB and Hounsfield unit for each stone was measured in Computed Tomography (CT).

RESULTS:

We classified the stones according to their appearance on KUB to Radio-Opaque stone (71 stones) and Radio-Lucent stone (29 stones).

By statistical analysis, we found that the cut-off value of HU was 573, with a sensitivity of 97.2% and specificity of 93.1%.

CONCLUSION

Find the cut-off value of the Hounsfield unit (HU), which is a value in the classification of gravel according to their appearance.

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References

Huang CC, Chuang CK, Wong YC, Wang LJ, Wu CH. Useful prediction of ureteral calculi visibility on abdominal radiographs based on calculi characteristics on unenhanced helical CT and CT scout radiographs. Int J Clin Pract. 2009;63:292–298. [PubMed] [Google Scholar]

Miller NL, Lingeman JE. Management of kidney stones. BMJ. 2007;334:468–472. [PMC free article] [PubMed] [Google Scholar]

Türk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M, Seitz C Guidelines on urolithiasis: European Association of Urology Guidelines, 2014 [Google Scholar]

Gupta NP, Ansari MS, Kesarvani P, Kapoor A, Mukhopadhyay S. Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. BJU Int. 2005;95:12851288. [PubMed] [Google Scholar]

Pareek G, Hedican SP, Lee FT, Nakada SY. Shock wave lithotripsy success determined by skin-to-stone distance on computed tomography. Urology. 2005;66:941–944. [PubMed] [Google Scholar]

Hameed DA, Elgammal MA, ElGanainy EO, Hageb A, Mohammed K, El-Taher AM, Mostafa MM, Ahmed AI. Comparing non-contrast computerized tomography criteria versus dual X-ray absorptiometry as predictors of radio-opaque upper urinary tract stone fragmentation after electromagnetic shockwave lithotripsy. Urolithiasis. 2013;41:511–515. [PubMed] [Google Scholar]

el-Assmy A, Abou-el-Ghar ME, el-Nahas AR, Refaie HF, Sheir KZ. Multidetector computed tomography: role in the determination of urinary stones composition and disintegration with extracorporeal shock wave lithotripsy--an in vitro study. Urology. 2011;77:286–290. [PubMed] [Google Scholar]

El-Assmy A, El-Nahas AR, Abou-El-Ghar ME, Awad BA, Sheir KZ. Kidney stone size and Hounsfield units predict successful shockwave lithotripsy in children. Urology. 2013;81:880–884. [PubMed] [Google Scholar]

Pearle, M.S., Calhoun, E.A., Curhan, G.C., and Urologic Diseases of America Project, 2005. Urologic diseases in America project: urolithiasis. The Journal of Urology, 173 (3), pp.848-857.

Ouzaid I, Al-Ohtani S, Dominique S, Hupertan V, Fernandez P, Hermieu JF, Delmas V, Ravery V. A 970 Hounsfield units (HU) threshold of kidney stone density on non-contrast computed tomography (NCCT) improves patients’ selection for extracorporeal shockwave lithotripsy (ESWL): evidence from a prospective study. BJU Int. 2012;110:E438–E442. [PubMed] [Google Scholar]

Gücük A, Kemahlı E, Üyetürk U, Tuygun C, Yıldız M, Metin A. Routine flexible nephroscopy for percutaneous nephrolithotomy for renal stones with low density: a prospective, randomized study. J Urol. 2013;190:144–148. [PubMed] [Google Scholar]

Kim JW, Chae JY, Kim JW, Oh MM, Park HS, Moon du G, Yoon CY. Computed tomography-based novel prediction model for the stone-free rate of ureteroscopic lithotripsy. Urolithiasis. 2014;42:75–79. [PubMed] [Google Scholar]

Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M, Knoll T, Lingeman JE, Nakada SY, Pearle MS, et al. 2007 Guideline for the management of ureteral calculi. Eur Urol. 2007;52:1610–1631. [PubMed] [Google Scholar]

Erturhan S, Bayrak O, Mete A, Seckiner I, Urgun G, Sarica K. Can the Hounsfield unit predict the success of medically expulsive therapy? Can Urol Assoc J. 2013;7:E677–E680. [PMC free article] [PubMed] [Google Scholar]

Scales CD, Jr, et al. Urinary stone disease: advancing knowledge, patient care, and population health. Clin J Am Soc Nephrol. 2016;11:1305–1312. [PMC free article] [PubMed] [Google Scholar]

Chua ME, Gomez OR. Sapno LD. Lim SL. Morales ML Jr.2014, Use of computed tomography scout film and Honsfield unit of computed tomography scan in predicting the radio-opacity of urinary calculi in plain kidney, ureter, and bladder

Smith-Bindman R, et al. Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med. 2014;371:1100–1110. [PubMed] [Google Scholar]

Sfoungaristos, S., Kavouras, A., Kanatas, P., Duvdevani, M. and Perimenis, P., 2014. Early hospital admission and treatment onset may positively affect the spontaneous passage of ureteral stones in patients with renal colic. Urology, 84 (1), pp.16-21.

Coursey CA, et al. ACR Appropriateness Criteria (R) acute onset flank pain-suspicion of stone disease. Ultrasound Q. 2012;28:227–233. [PubMed] [Google Scholar]

Memarsadeghi M, et al. Unenhanced multi-detector row CT in patients suspected of having urinary stone disease: effect of section width on diagnosis. Radiology. 2005;235:530–536. [PubMed] [Google Scholar]

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Published

2024-01-08

How to Cite

Flayyih, D. S. R. ., Radhi, D. F. K. ., & Tuama, D. I. M. . (2024). Role of Computed Tomography in Differentiation of Radio-Lucent Stones from Radio-Opaque Stones in The Renal System Depending on Attenuation Measurements (Hounsfield Unit). INTERNATIONAL JOURNAL OF HEALTH SYSTEMS AND MEDICAL SCIENCES, 3(1), 1–9. https://doi.org/10.51699/ijhsms.v3i1.3279

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