Renal pelvisteki idrarın üreter taşının impaktasyonunu belirlemedeki rolü

Yıl 2021, Cilt: 4 Sayı: 2, 148 - 156, 31.08.2021

Deniz Abat Fatih Gokalp Ali Çam Onur Karslı

Öz

Renal pelvisteki idrarın üreter taşının impaktasyonunu belirlemedeki rolü
Özet
Amaç: Üreter taşının olduğu taraftaki renal pelvisin Hounsfield Ünitesi değerinin taşın impaktasyonu hakkında fikir verip veremeyeceğini değerlendirmek.
Materyal ve method: Üreter taşı nedeniyle opere edilen hastaların, demografik verileri ile operasyon öncesi çekilen kontrastsız tomografi filmine göre hesaplanan, taşın transvers ve en uzun boyutu, üst üreterin çapı, üst üreterin alt üreter çapına oranı, taş dansitesi, renal pelvisin ön arka çapı ile renal pelvisteki idrarın ve mesanedeki idrarın HU değeri, taşın impakte olduğu ve olmadığı iki grup arasında karşılaştırıldı.
Bulgular: Hastaların ortanca yaşı 44 (37 - 53) yıl olup, %86.4’ü erkekti. Yaş, cinsiyet, komorbidite, taraf ve taş lokalizasyonu bakımından gruplar arasında fark yoktu (p=0.067, p=0.073, p=0.093, p=0.0141 ve p=0.074, sırasıyla). Renal pelvisteki idrarın HU değeri ile mesanedeki idrarın HU değeri gruplar arasında karşılaştırıldığında anlamlı farklılık görülmedi (p=0.511, p=0.376, sırasıyla). Mesanedeki idrar dansitesinin renal pelvis dansitesine oranına bakıldığında gruplar arasında anlamlı fark yoktu (p=0.461). Transvers taş uzunluğu, en uzun taş boyutu, üst üreter çapı ve üst üreter çapının alt üreter çapına oranı, taş dansitesi ve renal pelvis AP çapı, taş impaktasyonu olan grupta istatistiksel olarak anlamlı olacak şekilde daha büyüktü (p<0.001, p<0.001, p<0.001, p=0.025, p=0.016 ve p<0.001 sırasıyla)
Sonuç: Transvers taş uzunluğunun, taşın en uzun boyutunun, üst üreter çapının, üst üreter çapının alt üreter çapına oranının, renal pelvis ön arka çapının ve taşın HU ünitesindeki artışın impaktasyonla ilişkisi gösterilmiştir. Renal pelvisin idrar HU değerinin impaktasyonla ilişkisi bulunamamıştır.
Abstract
Purpose: To evaluate whether the Hounsfield Unit value of the renal pelvis on the side of the ureteral stone has any predictive value about the impaction of the stone.
Material and method: Demographic data of the patients who were operated for ureteral stones and preoperative radiological parameters such as the transverse and longest size of the stone, the diameter of the upper ureter, the ratio of the upper ureter to the lower ureter diameter, the stone density, the anterior-posterior diameter of the renal pelvis, HU values of urine in the renal pelvis and urine in the bladder based on noncontrast computerized tomography were compared between the two groups with and without impacted stone.
Results: The median age of the patients was 44 (37 - 53) years, and 86.4% of patients were male. There was no difference between the groups in terms of age, gender, comorbidity, side and stone localization (p=0.067, p=0.073, p=0.093, p=0.0141 and p=0.074, respectively). When the HU value of urine in the renal pelvis and the HU of urine in the bladder were compared between the groups, no significant difference was observed (p=0.511, p=0.376, respectively). When the ratio of urinary density in the bladder to the renal pelvis density was analyzed, there was no significant difference between the groups (p=0.461). Transverse stone length, longest stone size, upper ureter diameter, and the ratio of upper ureter diameter to lower ureter diameter, stone density, and renal pelvis AP diameter were statistically significantly greater in the stone impaction group (p<0.001, p<0.001, p<0.001, p=0.025, p=0.016, and p<0.001, respectively)
Conclusion: The significant relationship were found between the length of the transverse stone, the longest dimension of the stone, the diameter of the upper ureter, the ratio of the diameter of the upper ureter to the diameter of the lower ureter, the anterior-posterior diameter of the renal pelvis and the increase in the HU unit of the stone with impaction status. The urinary HU value of the renal pelvis was not found to be associated with impaction status.

Anahtar Kelimeler

İmpaktasyon, Oran, Üreter taşı

Kaynakça

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