Unenhanced CT findings can predict the development of urinary calculi in stone-free patients.
Summary of "Unenhanced CT findings can predict the development of urinary calculi in stone-free patients."
OBJECTIVES:
To determine if calcium deposits in the papillae can be identified by unenhanced computed tomography (uCT) even before renal stones develop.
METHODS:
A retrospective review of 413 patients with calculi identified 31 patients (stone-forming group) with a history of urinary tract calculi with a calculus demonstrated by uCT and a stone-free uCT before calculi had developed. The control group (n = 31) was composed of live kidney donors with no history of calculi and a stone-free uCT. CT attenuation was measured in all CTs using two regions of interest of 0.05 cm(2) and 0.1 cm(2) over the tip and the neighbouring area of the papillae. Student's and Wilcoxon t-tests were used for comparing results in the two groups.
RESULTS:
The attenuation of the tip of the papilla was higher in the stone-forming group when compared to the controls after (45.2 HU versus 32.1 HU, P = 0.001) and even before frank calculi had developed (44.2 HU versus 32.1 HU, P = 0.003). There was no significant difference in papillary attenuation in the stone group before and after calculi had developed (45.2 HU versus 44.2 HU, P = 0.82).
CONCLUSION:
Stone-forming patients exhibit higher papillary density even before calculi develop. This could define a population at risk of developing calculi. KEY POINTS : • Unenhanced CT shows high density papillae in patients who subsequently develop calculi. • These probably correlate with Randall's plaques. • Subjects at high risk of developing stone disease could be identified. • Targeted prophylaxis might be helpful.
Affiliation
Urology Department, Hospital Clínic Barcelona, Calle Villarroel 170, 08036, Barcelona, Spain, alexciudin@yahoo.com.
Journal Details
This article was published in the following journal.
Name: European radiology
ISSN: 1432-1084
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22572987
- DOI: http://dx.doi.org/10.1007/s00330-012-2463-9
Medical and Biotech [MESH] Definitions
Urinary Bladder Calculi
Stones in the URINARY BLADDER; also known as vesical calculi, bladder stones, or cystoliths.
Cystotomy
Surgical incision or puncture into a URINARY BLADDER. Cystotomy may be used to remove URINARY CALCULI, or to perform tissue repair and reconstruction.
Urinary Calculi
Low-density crystals or stones in any part of the URINARY TRACT. Their chemical compositions often include CALCIUM OXALATE, magnesium ammonium phosphate (struvite), CYSTINE, or URIC ACID.
Calculi
An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones.
Lithotripsy, Laser
Fragmentation of CALCULI, notably urinary or biliary, by LASER.
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