Analysis Of The Relationship Between Renal Anatomical Structure And High Incidence Of Unilateral Renal Calculi By 3D CT Reconstruction And 3D Printing

ObjectiveTo explore the relationship between the renal anatomical structure and the formation of renal calculi by using 3D CT reconstruction and3 D printing technology.To reveal the possible anatomical factors of high incidence of unilateral renal calculi in the same internal environment from the anatomical structure of the kidney in the case of unilateral renal calculi,so as to provide theoretical basis for the treatment and prevention of renal calculi.MethodsThe diameter of ureteropelvic junction(UPJ),calyceal and minor calyceal amount,calculous calyceal length and calyceal neck width,infundibulotransvers angle(ITA),infundibulopelvic angle(IPA)were measured and compared by analyzing CTU 3D reconstructed angiogram among calculous kidneys,noncalculous kidneys of noncalculous patients and noncalculous kidneys of calculous patients,which were recruited in The 1st Affiliated Hospital of GDPU and The 2nd Affiliated Hospital of GZMU from2017 to 2019,seven-six patients were enrolled in this study.Data of 3D printing models and 3D reconstructed angiogram were also compared.All the data were analysed with SPSS 17.0 software.Result1.The ureteropelvic junction diameter of calculous kidney range from 2.7 to 8.2mm(mean 5.02 mm),that of opposite kidney range from 2.9 to8.4mm(mean 5.22 mm),and that of healthy kidney range from 3.3 to9.6mm(mean 5.24 mm);The difference among the ureteropelvic junctiondiameter of calculous kidney,opposite kidney and healthy kidney is not statistically significant(P>0.05).2.The minimum calyceal neck width of the calculous kidney range from 2.1 to 8.5mm(mean 4.63 mm),that of the opposite side kidney range from 2.1 to 9.8mm(mean 5.19 mm),and that of the healthy kidney range from3.3 to 9.2mm(mean 5.52 mm).There is statistically significant difference among the three groups(P < 0.05).3.The length of calculous kidney calyces range from 7.5 to 27.9mm(mean 15.81mm),that of the opposite side kidney range from 7.0 to 25.0mm(mean 14.66 mm),and that of the healthy kidney group range from8.2-24.2mm(mean 14.58mm).There was no statistical difference among the three groups(P > 0.05).4.The infundibulopelvic angle(IPA)of calculous kidney range from 56.0°to 127.8°(mean 90.46°),that of opposite kidney range from 70.0°to142.1°(mean 96.15°),and that of healthy kidney range from 77.4°to124.0°(mean 101.45°).There is statistically significant difference among the three groups(P < 0.05).5.The infundibulotransvers angle(ITA)of calculous kidney range from 37.0°to 86.0°(mean 56.9°),that of opposite kidney range from 23.5°to82.3°(mean 50.19°),and that of healthy kidney range from 20.3°to 81.6°(mean50.02°).The difference among the three groups is statistically significant(P <0.05).6.There is no statistically significant difference among the three groups(P > 0.05).7.No significance was found from 3D printing models and 3D reconstructed angiogram.ConclusionCalyceal neck width,IPA and ITA may be the anatomical factors that related to the stone formation.The inconsistency of these factors in bilateral kidneys of the same internal environment leads to the high incidence of unilateral kidney stone.CT three-dimensional reconstruction and 3D printing technology is an intuitive and applicable observation method of renal anatomy.The high incidence of unilateral renal calculi in the same machine may be related to the abnormal renal anatomy,it is still worth further researching.