Prediction of calcium level in melamine-related urinary calculi with helical CT: diagnostic performance evaluation and clinical significance.

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  • Additional Information
    • Source:
      Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 0364311 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1434-0879 (Electronic) Linking ISSN: 03005623 NLM ISO Abbreviation: Urol Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: Berlin, Springer-Verlag.
    • Subject Terms:
      Calcium/*analysis ; Tomography, Spiral Computed/*methods ; Triazines/*toxicity ; Urinary Calculi/*chemistry; Humans ; Retrospective Studies ; Urinary Calculi/diagnostic imaging ; Urinary Calculi/therapy
    • Abstract:
      The aim of the study was to investigate the relationship between CT-attenuation and stone calcium level in melamine-related urinary calculi (MRUC). A total of 25 MRUC with known composition and calcium level were included (11 uric acid stones, 2 calcium oxalate stones and 12 mixture stones of uric acid and calcium oxalate). Of all, 18 renal stones accepted alkalization therapy except for 5 lower urinary tract stones and 2 stones of unknown position. With well-matched composition, 61 adult urinary stones were included as controls. Every stone was scanned by helical CT (80 kV/120 kV, 300 mA, pitch 0.625 mm) and the highest CT-attenuation value measured. CT-attenuation values of MRUC increased gradually from uric acid stones, mixture stones to calcium oxalate stones, but were always lower than the values of controls. Furthermore, a strong positive correlation was found between stone CT-attenuation value and stone calcium level (n = 25, r (80kV) = 0.883, p = 0.000; r (120kV) = 0.855, p = 0.000). Compared with alkalization-therapy-alone group, stone CT-attenuation values and stone calcium level in the comprehensive-therapy group were significantly greater (CT(80kV) 1,057 ± 639 vs. 172 ± 61 HU, p = 0.001; CT(120kV) 783 ± 476 vs. 162 ± 60 HU, p = 0.001; Ca 19.83 ± 7.48% vs. 1.30 ± 1.51%, p = 0.000). Fisher's exact test suggested that the stones with higher CT-attenuation values tended to resist alkalization when 400 HU served as the cutoff value (P (80kV) = 0.002, P (120kV) = 0.000). In conclusion, the study was the first to illustrate that the CT-attenuation value could reflect calcium level in MRUC and found that stones with higher CT-attenuation value were not amenable to alkalization because they probably contained greater calcium. For those patients, we believe that comprehensive therapy will be the best choice.
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    • Accession Number:
      0 (Triazines)
      N3GP2YSD88 (melamine)
      SY7Q814VUP (Calcium)
    • Publication Date:
      Date Created: 20110820 Date Completed: 20120914 Latest Revision: 20211020
    • Publication Date:
      20240829
    • Accession Number:
      10.1007/s00240-011-0413-7
    • Accession Number:
      21853242