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Title: Assessment of stone composition in the management of urinary stones
Authors: Kittinut Kijvikai
J. J M De La Rosette
Mahidol University
Academic Medical Centre, University of Amsterdam
Keywords: Medicine
Issue Date: 1-Feb-2011
Citation: Nature Reviews Urology. Vol.8, No.2 (2011), 81-85
Abstract: Several explanations have been suggested to account for the failure of extracorporeal shockwave lithotripsy (ESWL) treatment in patients with urinary stones, including large stone volume, unfavorable stone location or composition and the type of lithotriptor used. Unfavorable stone composition is considered a major cause of failure of ESWL treatment, and consequently knowledge of the stone composition before treatment is initiated is desirable. Plain abdominal radiographs cannot accurately determine either stone composition or fragility, and although the CT attenuation value in Hounsfield units (HU) (that is, normalized to the attenuation characteristics of water) is useful, this parameter has limited value as a predictor of stone composition or the response to ESWL treatment. By contrast, stone morphology as visualized by CT correlates well with both fragility and susceptibility to fragmentation by ESWL. For patients prone to recurrent calculi, analyses of stone composition are especially important, as they may reveal an underlying metabolic abnormality. The development of advanced imaging technologies that can predict stone fragility is essential, as they could provide extra information for physicians, enabling them to select the most appropriate treatment option for patients with urinary stones. © 2011 Macmillan Publishers Limited. All rights reserved.
ISSN: 17594820
Appears in Collections:Scopus 2011-2015

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