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Kapanadze L.B.1, Serova N.S.1, Rudenko V.I.1, Kuzmicheva G.M.2 Aleksandrova K.A.1, Novikov I.A.1

Purpose. To improve the diagnosis of urolithiasis using the latest technique – dual-energy computed tomography (DECT). Materials and methods. A prospective study of a group of 91 (100%) patients was conduct-ed at the department of radiology and urology at the Russian-Japanese Center in Sechenov University. All patients underwent a dual-energy CT scan to predict the chemical composi-tion of urinary stones "in vivo". All patients underwent surgical treatment after diagnostics: distance lithotripsy (DLT), percutaneous nephrolithotripsy (PHNLT), contact ureterolithotrip-sy (CULT). All the stones after operations were subjected to physico-chemical analysis (X-ray phase analysis, infrared spectroscopy) in order to verify the composition. Further, the diag-nostic value of the dual-energy computed tomography was assessed by comparing the DECT results with the physico-chemical analysis data. Results. Using DECT in the preoperative period, the following results were obtained: 40 patients had vevellit stones, 34 patients had Ca-containing stones without vevellit, 10 patients had stones with uric acid, in 7 patients stones were classified in the group of cys-tine/struvite. After verification studies in the postoperative period, the following urinary stone composition was determined: 42 stones – vevellit, 34 stones – Ca-containing stones without vevellit, 10 stones with uric acid, 5 stones – struvite stones. At the same time the following results were obtained incorrectly using DECT: 7 stones with vevellit from which 4 stones were postoperatively confermed to the group of Ca-containing stones without vevellit, 3 stones – struvite/cystine stones; 4 Ca-containing stones without vevellite were classified in the group of the vevellite; 2 struvite stones: 1 stone was incorrectly assigned to the group of uric acid, 1 stone – to the group of the vevellite; 1 stone uric acid was incorrectly assigned to the group of struvite stones. It should also be noted that 1 stone had a mixed composition (uric acid 70% + vevellit 23% + veddellite 7%), according to the results of DECT it was incor-rectly assigned to the group of stones from uric acid, at the same time the prevailing compo-nent was determined correctly. Conclusions. In order to predict the chemical composition of the stone "in vivo" with a high degree of reliability DECT in the preoperative period can differentiate not only the urate and Ca-containing stones, but also separately identify the stones in which vevellit is the predominant component. The detailed differentiation of Ca-containing stones, as well as of more rare stones, such as struvite and cystine, requires further studies with more signifi-cant groups of stones.

1 - I.M. Sechenov First Moscow State Medical University (Sechenov University). 2 - MIREA - Russian Technological University Moscow, Russia


Keywords:: multispiral computed tomography (MSCT), dual-energy computed tomography (DECT), uro-lithiasis, urinary stones, physico-chemical analysis.


Corresponding author: Kapanadze L.B. e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Kapanadze L.B., Serova N.S., Rudenko V.I., Kuzmicheva G.M., Aleksandrova K.A., Novikov I.A. Results of application of dual-energy computed tomography in the diagnosis of urolithia-sis. REJR 2018; 8(2):94-104. DOI:10.21569/2222-7415-2018-8-2-94-104.

Received: 12.02.2018 Accepted: 16.03.2018