Ultrasonography Is Not Inferior to Fluoroscopy to Guide Extracorporeal Shock Waves during Treatment of Renal and Upper Ureteric Calculi: A Randomized Prospective Study.
Ultrasonography Is Not Inferior to Fluoroscopy to Guide Extracorporeal Shock Waves during Treatment of Renal and Upper Ureteric Calculi: A Randomized Prospective Study.
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DOI：
10.1155/2017/7802672
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发表时间：
2017
影响因子：
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通讯作者：
Merckx L
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文献类型：
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作者：
Van Besien J;Uvin P;Hermie I;Tailly T;Merckx L
研究冲击波碎石术（SWL）中使用的可视化方式（超声或透视）是否会影响两种成像方式均可选择的临床结果。2014年11月至2016年7月，114例不透明上尿路结石患者在一项前瞻性、开放标签、单中心研究中随机分为超声或透视引导下的SWL组。使用了标准化的SWL协议。比较无结石率和阳性转归率（无结石或无症状残余碎片≤4 mm）。超声引导组结石清除率为52%，透视引导组为42% (p = 0.06)；超声引导组阳性转归率为79%，透视引导组为70% （p = 0.28）。这些结果没有显著差异，但根据独立比例的Wilson置信区间（非劣效限10%）证明是非劣效性的。SWL会话的平均次数无显著差异（p = 0.4）。我们的研究表明，超声引导下的SWL临床效果不逊于透视引导下的SWL，且不需要电离辐射。
To investigate whether the visualization modality (ultrasound or fluoroscopy) used during shockwave lithotripsy (SWL) affects the clinical outcome in those instances where both imaging modalities are optional. Between November 2014 and July 2016, 114 patients with radiopaque upper urinary tract calculi were randomly assigned to an ultrasound- or fluoroscopy-guided SWL group in a prospective, open-label, single-center study. A standardized SWL protocol was used. The stone-free rate and the positive outcome rate (stone-free or asymptomatic residual fragments ≤ 4 mm) were compared. The stone-free rate was 52% in the ultrasound-guided group compared to 42% in the fluoroscopy-guided group (p = 0.06) and the positive outcome rate was 79% in the ultrasound-guided group compared to 70% in the fluoroscopy-guided group (p = 0.28). These results were not significantly different but proved to be noninferior based on a Wilson confidence interval of independent proportions (noninferiority limit 10%). The mean number of SWL sessions was not significantly different (p = 0.4). Our study demonstrated that the clinical results of ultrasound-guided SWL were not inferior to the results of fluoroscopy-guided SWL, while no ionizing radiation is needed.