Role of Acoustic Value Histogram of Urinary Stone on Ultrasonography as Predictor of amenability to Extracorporeal Shock Wave Lithotripsy


Hamid Talari 1 , Yaser Hamidian 1 , Reza Esfandiary 1 , *

1 Department of Radiology, Kashan University of Medical Sciences, Kashan, IR Iran

How to Cite: Talari H, Hamidian Y, Esfandiary R. Role of Acoustic Value Histogram of Urinary Stone on Ultrasonography as Predictor of amenability to Extracorporeal Shock Wave Lithotripsy, Iran J Radiol. Online ahead of Print ; 11(30th Iranian Congress of Radiology):e21416. doi: 10.5812/iranjradiol.21416.


Iranian Journal of Radiology: 11 (30th Iranian Congress of Radiology); e21416
Published Online: February 28, 2014
Article Type: Research Article


Background: Extracorporeal shock wave lithotripsy (ESWL) is a primary treatment for renal and ureteral stones. Failure in this treatment may result in extra costs and also unwanted complications such as hemorrhage and renal edema for the patients.

Objectives: Thus, the ability to estimate the possibility of destruction of stone with this method will be useful for satisfactory medical outcome. A body of evidence indicates that with the use of histogram data which is obtained by CT scan, the possibility of destruction of stone by ESWL can be estimated. Given the convenience of US (lower cost, less risk of radiation), efforts to predict the possibility of destruction of stone by applying histogram findings obtained by US, as addressed in this presentation, may be justifiable.

Patients and Methods: A total of 76 renal and ureteral radiopaque stones scheduled for treatment with extracorporal shock wave lithotripsy were included in this study. Stones less than 5 mm or greater than 20 mm were excluded. Histograms were graphed from US. This parameter was compared between the treatment success and treatment failure groups.

Results: Of 76 stones, 7 were excluded, 55 were in success group, and 14 were in the failure group. The histogram was significantly different between the two groups (P ? 0.05) with accuracy of 80%. Furthermore, the histogram figure was the independent predictor of success or failure of ESWL.

Conclusions: Our results have suggested that histogram figure is a good predictor of stone amenability to ESWL. The treatment modality of the stone should be selected according to the histogram figure as a practical, simple and predictive index.

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