Spiral CT To Determine The Chemical Composition Of Urinary Calculi In Vivo

Objective to investigate the possibility of Spiral CT to determine the chemical composition of upper urinary calculi and to help for clinical treatment and prevention of stone recurrence.Methods 1.Case selection: October 2009 to February 2011 period, the First Affiliated Hospital of Suzhou University, Department of Urology 131 cases of upper urinary tract stones in hospitalized patients, preoperative helical CT scan, scan parameters: 120kV, 330mA, 6.50mm Thickness.2. Measurement data: Two doctors use PACS system in the soft tissue region to measure the area and the average CT values of interest window measuring stones (ROI) .3.Specimen Collection: Collection of selected cases, open surgery or laparoscopic surgery after removal of the stone samples were 131 cases, detailed records of stones in patients with general information and stone size, shape, texture, color, wash after dry bag aside.4.Chemical analysis of stone composition: The Institute of Urology, Guangzhou Medical College, to provide reagents for chemical analysis of stones collected stones of all the ingredients.5. Statistical analysis: Application of statistical software SPSS18.0 data in each group respectively, completely randomized design analysis of variance and LSD test, understand the various components of the average CT value of the stones if the difference between the statistical significance.Results Detected by chemical analysis, five categories of pure stones were found in 90 cases,six of 41 patients with mixed stones. Urinary uric acid and ammonium stones in 21 cases (16%), calcium oxalate stones in 39 cases (29%), calcium phosphate stones in 12 patients (9%), calcium carbonate stones in 10 patients (8%), magnesium ammonium phosphate stones in 8 cases (6 %); carbonated apatite in 6 cases (5%), uric acid + calcium oxalate stones in 10 patients (8%), calcium oxalate + calcium phosphate stones in 16 patients (12%), calcium + magnesium ammonium phosphate stones in 3 cases (2 %), uric acid + calcium phosphate stones in 4 cases (3%), uric acid + carbonate apatite in 2 cases (2%). The average CT value of category five pure stones were: urinary uric acid and ammonium stones (349±78 HU), calcium oxalate stones (1058±71 HU), calcium phosphate stones (1126±67 HU), calcium carbonate stones (770±87 HU), magnesium phosphate Ammonium stones (631±76 HU); Six mixed stones mean CT value were: carbonate apatite (948±90 HU), uric acid + calcium oxalate stones (670±73 HU), calcium oxalate + calcium phosphate stones (1335±51 HU), calcium + magnesium ammonium phosphate stones (953±72 HU), uric acid + calcium phosphate stones (599±202 HU), uric acid + carbonate apatite (817±124 HU). The average CT value of the five pure stone was used to compare between the full design analysis of variance and LSD test the difference among the groups were statistically significant (P <0.05), three types of mixed stones between the average CT value of the LSD test after each The difference between the groups was statistically significant (P <0.05), LSD test done between eight stones, of which magnesium ammonium phosphate and uric acid + mixed calcium oxalate stones mean CT value between the two was no significant difference (P = 0.26 ), Other differences between the groups was statistically significant (P <0.05).Conclusion 1. The chemical composition in patients with upper urinary tract calculi in soochow mainly composed of calcium oxalate, uric acid and calcium phosphate, followed by composition, calcium carbonate, magnesium ammonium phosphate, carbonated apatite composition less, this experiment did not find cystine stones .2. The five specific categories of pure and three mixed urinary stones on the upper urinary tract calculi chemical composition of the average CT values were initially identified. 3. Non-enhanced spiral CT scanning can differentiate uric acid stones, calcium oxalate stones, calcium stones, calcium stones, carbonated apatite, calcium oxalate + calcium phosphate stones six stone composition. Magnesium ammonium phosphate and calcium oxalate+uric acid mixed stones can not be distinguished.4. Spiral CT to determine the chemical composition of urinary calculi with the clinical feasibility of the treatment strategy of urinary tract calculi with a guide, recommended before treatment in the application of urolithiasis.