الفهرس 
الملخص العربي
Stone formationOnly 14 pages are availabe for public view
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Abstract
Urolithiasis is one of the most common disorders of the urinary tract. It is an ancient health problem. Evidence of kidney stones has been found in an Egyptian mummy estimated to be more than 7,000 years ago.
Shock wave lithotripsy (SWL) is a non invasive treatment modality for stones SWL has emerged as the primary treatment of choice for renal calculi less than 2 cm. It is the least invasive treatment modality and high success rates have been reported for calculi along the whole urinary tract.
SWL has been recommended as first line treatment for proximal ureteral calculi less than 1cm
It would be advantageous to predict the liability of the stone to disintegrate by SWL before offering the patient the treatment.
The aim of our work is to assess the value of non contrast computed tomography (NCCT) as a possible predictor of renal stone disintegration by shock wave lithotripsy (SWL) in comparison to densitometry (DXA).
This study included 100 patients, 73 males and 27 females. Only 76 patients were available for follow up. The 76 patients included 58 male (76.3%) and 18 females (23.7%). Age of the patients ranged from 13-70 years (mean 37.42 ±14.2 y). Mean BMI was 24.3± 5.1 kg/m
All patients subjected to the following investigation:
1-Abdominal ultrasound
2-KUB film
3-DXA to calculate stone mineral density (SMD) and stone mineral content (SMC)
4-multidetector row helical CT scanner -
5- SWL was performed with electromagnetic DoliS lithotripter.
Patients were evaluated 3 month after the last lithotripsy session by KUB and abdominal ultrasound. 27 of them subjected to stone analysis
The successful treatment was defined as stone free + complete fragmentation. The patients were categorized according to the SMC (≤ or > 0.65) and HU (≤ or > 1350). There are variations in the cut of value of HU between Authors ranged from 750 to more than 1000 HU in our study the cut of value that give significant difference in univariate analysis between the success and failure group was 1350 HU.
All the significant factors were analyzed in a multivariate analysis. SMC, NSWs were the only significant predictors of SWL success.
Our study concluded that DXA is more accurate, less invasive and less expensive than CT. Patients with a high SMC (> 0.65 gm) could be directly offered alternate methods of treatment, thus avoiding the burden of a failed SWL in terms of unnecessary cost and possible side effects. However DXA cannot identify radiolucent stone which is easily detected by CT.