Differences in Computed Tomography Density of the Renal Papillae of Stone Formers and Non-Stone-Formers: A Pilot Study
Differences in Computed Tomography Density of the Renal Papillae of Stone Formers and Non-Stone-Formers: A Pilot Study
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DOI：
10.1089/end.2008.9721
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发表时间：
2008-10-01
影响因子：
2.7
通讯作者：
Sahani, Dushyant V.
中科院分区：
文献类型：
--
作者：
Eisner, Brian H.;Iqbal, Ahsan;Sahani, Dushyant V.
目的：一般认为，肾结石患者肾乳头内的钙沉积物兰德尔斑块可能是结石形成的病灶。我们使用计算机断层扫描（CT）上的衰减测量（HU）检查结石患者和对照患者的肾乳头密度，以确定肾结石是否与肾乳头的放射学改变相关。材料和方法：对17例肾盏结石患者和15例年龄在10 ~ 15岁之间的患者的0.2cm（2）面积的肾乳头进行了Hounsfield密度测量。匹配的对照患者进行。对所有患者的肾乳头上、中、下极盏进行测量。结果：肾结石患者和对照组患者的平均年龄（41.2岁对42.2岁，p = 0.82）和基线血清肌酐（0.86 mg/dl对0.93 mg/dl，p = 0.21）相似。肾盏结石患者肾乳头的平均Hounsfield密度显著大于对照组患者的位置匹配的乳头（54.4比36.6，p < 0.0001）。受累肾脏所有乳头的平均Hounsfield密度（i.例如，肾结石组的肾组织中有结石的肾组织中有结石的结石患者的无结石肾中所有乳头的平均Hounsfield密度显著大于对照患者（50.0比36.1，p < 0.0001）。在结石患者中，当比较受影响的肾脏与无结石的肾脏时，平均乳头Hounsfield密度没有差异（50.3对50.9，p = 0.59）。结论：与年龄匹配的对照组相比，肾结石患者的肾乳头Hounsfield密度显著增加。有结石肾盏、无结石肾盏和对侧无结石肾盏都是如此。肾结石患者肾乳头Hounsfield密度在有无结石肾间无差异。将来，这些信息可能有助于预测哪些患者可能发展为肾结石。
Purpose: It is thought that Randall's plaques, calcium deposits in the renal papillae of patients with nephrolithiasis, may serve as a nidus for stone formation. We examined the density of renal papillae in patients with stones and control patients using attenuation measurements (HU) on Computed Tomography (CT) to determine whether nephrolithiasis is associated with radiographic changes in renal papillae.Materials and Methods: Hounsfield density measurements of a 0.2cm(2) area of the renal papillae of 17 patients with a single renal calyceal calculus and 15 age- matched control patients were performed. Measurements were done for renal papillae upper, middle, and lower pole calyces for all patients. Statistical comparisons were made using the student's t-test.Results: Patients with nephrolithiasis and control patients were similar with respect to mean age (41.2 years versus 42.2 years, p = 0.82) and baseline serum creatinine (0.86 mg/dl versus 0.93 mg/dl, p = 0.21). Mean Hounsfield density of renal papillae of stone patients in calyces with stones was significantly greater than that of location- matched papillae from control patients (54.4 versus 36.6, p < 0.0001). Mean Hounsfield density of all papillae of the affected kidney (i. e., kidney with stone) in stone patients was significantly greater than that of control patients (50.9 versus 36.4, p < 0.0001). Mean Hounsfield density of all papillae in the stone- free kidney of stone patients was significantly greater than that of control patients (50.0 versus 36.1, p < 0.0001). In stone patients, when comparing the affected kidney with the stone- free kidney, there was no difference in mean papilla Hounsfield density (50.3 versus 50.9, p = 0.59).Conclusions: Hounsfield density of the renal papilla is significantly increased in patients with nephrolithiasis when compared with age- matched controls. This is true of calyces with stones, calyces without stones in kidneys with stones, and calyces of the contralateral stone- free kidney. There is no difference in renal papilla Hounsfield density between kidneys with and without stones in patients with nephrolithiasis. In the future, this information may be useful in predicting which patients may develop nephrolithiasis.