Retention and growth of urinary stones: insights from imaging
Retention and growth of urinary stones: insights from imaging
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DOI：
10.5301/jn.5000208
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发表时间：
2013-01-01
影响因子：
3.4
通讯作者：
McAteer, James A.
中科院分区：
文献类型：
--
作者：
Williams, James C., Jr.;McAteer, James A.
最近肾结石的研究受益于两种特殊的成像：使用高质量仪器对患者肾脏进行内窥镜研究，以及使用显微计算机断层扫描（microCT）检查结石。这些因素的结合提供了新的证据，表明结石在达到临床相关尺寸之前保留在肾脏中的机制不止一种。这篇综述介绍了什么是已知的结石的形成兰德尔的斑块，形成的结石导管塞和结石的方式可能会在肾盏或盆腔空间内的自由溶液中生长。尿石症的研究需要认识到，任何一组“结石形成者”都可能包括那些在结石形成机制是其结石的主要途径方面存在根本差异的患者。基于哪种机制（或机制组合）导致其疾病的患者的分离对于推进尿石症领域的研究将是重要的。
Recent work in nephrolithiasis has benefited from 2 special kinds of imaging: endoscopic study of patient kidneys with high-quality instruments, and examination of stones with microscopic computed tomography (micro CT). The combination of these has provided new evidence that there is more than 1 mechanism by which stones are retained in the kidney until they achieve sizes to be clinically relevant. This review describes what is known about the formation of stones on Randall's plaque, the formation of stones on ductal plugs and the ways in which stones may grow in free solution within the calyceal or pelvic spaces. Studies of urolithiasis need to recognize that any group of "stone formers" likely includes patients who differ fundamentally regarding which mechanism of stone formation is the primary route for their stones. Separation of patients on the basis of which mechanism (or combination of mechanisms) underlies their disease will be important for advancing research in the area of urolithiasis.