CLINICAL RELEVANCE OF CT VALUE ASSESSMENT: ENHANCING PRECISION IN URINARY STONE TREATMENT

Abstract

Background:

Urinary stone disease poses a significant health burden globally, impacting approximately 15% of the population. Ethnic variations in prevalence and the high recurrence rate underscore the complexity of this urological disorder. This study focuses on evaluating the role of CT values in discerning the chemical composition of upper urinary tract stones, offering insights into personalized treatment strategies.

Methods:

Conducted in Xinjiang, China, the retrospective study analyzed 120 patients with diverse demographics and stone types. Various surgical treatments were employed, and postoperatively, stone specimens underwent qualitative chemical composition analysis using infrared spectroscopy. CT values were recorded through scans conducted upon admission, and statistical analyses were performed to determine correlations between CT values and stone composition.

Results:

The study identified four types of pure stones and various mixed stones, with uric acid, calcium oxalate, hydroxyapatite, L-cystine, and struvite as the primary components. Significant differences in CT values were observed among pure uric acid stones, calcium oxalate stones, and hydroxyapatite stones. The average CT value to stone maximum transverse diameter ratio differentiated uric acid stones from calcium oxalate and hydroxyapatite stones. A CT value threshold of 550 HU exhibited high sensitivity (92.3%) and specificity (98.1%) in predicting pure uric acid stones.

Conclusion:

The study underscores the importance of considering ethnic variations in stone prevalence for accurate diagnosis. CT values, particularly in the soft tissue window, show promise in preoperative assessments, aiding differentiation between stone types. The average CT value to stone maximum transverse diameter ratio emerges as a useful metric, guiding treatment decisions based on stone hardness and structure. Despite inconclusive results in the bone window, the predictive accuracy of a 550 HU threshold for pure uric acid stones highlights the clinical utility of CT scans in enhancing diagnostic precision and personalized treatment strategies for urinary stone disease.