Ultrastructural Analysis of Urinary Stones by Microfocus Computed Tomography and Comparison with Chemical Analysis

Year 2016, Volume: 43 Issue: 2, 199 - 204, 01.06.2016

Tolga Karakan Emre Huri İlkan Tatar Hakan Hamdi Çelik Akif Diri Murat Bağcıoğlu Cankon Germiyanoğlu

Abstract

Objective: To investigate the ultra-structure of urinary system stones using micro-focus computed tomography (MCT), which makes non-destructive analysis and to compare with wet chemical analysis. Methods: This study was carried out at the Ankara Train­ing and Research hospital. Renal stones, removed from 30 patients during percutaneous nephrolithotomy (PNL) surgery, were included in the study. The stones were blindly evaluated by the specialists with MCT and chemi­cal analysis. Results: The comparison of the stone components be­tween chemical analysis and MCT, showed that the rate of consistence was very low (p<0.001). There was no significant relationship between the components of stone and its heterogeneity or homogeneity. No significant dif­ference was found between the stones with single com­ponent and those with multiple components in terms of its 3D structure being homogenous or heterogeneous and the presence of voids (p>0.05). It was also seen that there was no significant relation between its 3D structure being heterogeneous or homogenous. Conclusion: The stone analysis with MCT is a time con­suming and costly method. This method is useful to un­derstand the mechanisms of stone formation and an im­portant guide to develop the future treatment modalities.

Keywords

Computed tomography, micro, urinary stone analysis, urolithiasis

Üriner Sistem Taşlarının Mikrofokus Bilgisayarlı Tomografi ile Ultrastrüktürel Yapısının Analizi ve Kimyasal Analizle Karşılaştırılması

Abstract

Amaç: Mikro bilgisayarlı tomografi (MCT) yöntemiyle üriner
sistem taşlarının non- destruktif olarak ultrastrüktürel
yapısının incelenmesi ve kimyasal analiz ile karşılaştırılması
amaçlanmıştır
Yöntemler: Bu çalışma Ankara Eğitim ve Araştırma Hastanesinde
etik kurul onamını takiben yapıldı. Perkutan
nefrolitotomi sırasında 30 hastadan çıkarılan intakt taşlar
çalışmaya dahil edildi. Taşlar MCT ve takiben kimyasal
analiz yöntemleriyle analiz edildi.
Bulgular: Kimyasal analiz ile elde edilen taş komponentleriyle
MCT ile tespit edilen taş komponentleri arasında
bire-bir uyum değerlendirildiğinde uyum oranının istatistiksel
olarak çok düşük olduğu görülmüştür (p<0,001).
MCT yöntemine göre taşların içerdiği her bir bileşen yönünden
taşın üç boyutlu (3D) yapısının homojen veya heterojen
olma sıklığında istatistiksel olarak anlamlı değişimin
olmadığı görülmüştür. Tek ve çoklu içeriğe sahip olan
taşlar arasında taşın üç boyutlu yapısının homojen/heterojen
olma sıklığında ve içerdikleri havada boşluk olup
olmaması oranlarında istatistiksel olarak anlamlı farklılık
bulunmamıştır (p>0,05). Ayrıca taşın üç boyutlu yapısıyla
içeriğinin homojen ya da heterojen olması arasında bağlantı
saptanamamıştır.
Sonuç: Mikro bilgisayarlı tomografi ile taş analizinin oldukça
zaman alıcı ve çok yüksek maliyetli bir yöntem
olduğu görülmektedir. Bu yöntemin taş oluşum mekanizmaları
ve gelecekte yapılabilecek tedavi yöntemlerine
faydası olabileceği düşünülmektedir.

Keywords

Bilgisayarlı tomografi, mikro, üriner taş analizi, ürolitiyazis

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