The Application Of Three Dimensional CT For Renal Calculus In Preoperative Percutaneous Nephrolithotomy

Objective:1. To investigate the preoperative assessment and the stone fixing of three diamensions spiral computed tomography ,opacification and reestablishment in the percutaneous nephrolithotomy.2. To aid in formulating the operation as to finishing it successfully and completely.Methods:choosing 120 patients from the department of urology in the first affiliate hospital of Anhui medical college randomly , who were in hospital from June 2005 to December 2008,were from 22 to 65 years old that 46 was their average . among these patients ,61 was the suffers of multiple-stone,35 was the suffers of multiple-stone ,24 were the suffers of the staghorn stone(10 patients have the largest stones of diameter from 3.0~3.9 cm,6 patients have the largest stones of the diameter from 4.0~4.9 cm,8 patient has the largest stone of the diameter that exceeded 5.0 cm ).those patients were divided into 88 males and 32 females ,73 patients'stones were in their left kids ,while 77 patients'stones were in the opposite side kids. what's more ,14 patients were in the aggravations of hydronephrosis and nephrydrosis.all these patients have no the taboo for scanning in the imageology.at the same time ,all the patients were asked to scanned by KUB,BUS and 3D CT. According to the results from the 3D CT, all the patients were asked to getting rid of the stones by the PCNL. what's found in the operation were compare with the results from KUB,BUS.Results: 1.522 stones were found by the 3DCT,the rate of the detection is 91%,339 stones were found by KUB, the rate of the detection is 59%,321stones were found by BUS, the rate of the detection is 56%. comparing the date between the KUB and BUS, theχ~2 is 0. 69,P>0. 05, there is no statistical significance , comparing the date between the CT与BUS, theχ~2 is 14.33,P<0. 005,there is statistical significance,comparing the date between the CT与KUB, theχ~2 is 105.9,P<0. 001,there is statistical significance.2. All the 120 patients'operations are successful just after once under the inducted by BUS, 102 patients were operated on the single channel,12 patients'operations are successful for the dual pathways and 6 patients were operated for three-way joint. The most parts of the stones were crashed, the rest parts of the stones were scanned by CT in cue to MPR and three-dimensional reconstruction and then were crashed. Some stones are resided in the body of 11 patients , the rest were crashed and discharged after the first operation. the resided stones in one patient is in the blind zone of the endoscope, and another one stone of the diameter was 7-9 mm was negatively in the arm C that was made a definite diagnosis by BUS and discharged by ESWL. The time of all the operations spend 50 ~150 min, the average time was 100 min.Conclusions:1. Comparing 3DCT with KUB and BUS, the sensibility and the specificity are noble in the preoperative diagnosis.2. 3DCT is superordinary in the volume rendering and density resolution, which is ascendant in final diagnosis for the size ,number , location. Suggest 3DCT play the chiefly role in detection, diagnosis and PCNL operation of the multiple renal stones.