الفهرس 
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Abstract
Studying composition and Hounsfield Unite (HU) of urinary stone represents an important point for therapy planning. The ability to predict the stone composition before treatment would allow the urologist to choose patients for endolithotripsy instead of extracorporeal one.
One of the key determinants of appropriate management in patients with urinary calculi is the knowledge of stone composition .Determination of stone composition is of particular importance because (a) uric acid stones may be treated with urinary alkalinization as a first-line treatment, with surgical treatment being reserved for stones that do not respond to medical therapy; and (b) stones of certain compositions (eg, cystine stones), as well as calcium-based stones of certain attenuation, are extremely difficult to fragment with Shock Wave Lithotripsy (SWL).
This prospective study was subject to joint supervision between Urology and clinical Pathology departments, Menoufia University Hospitals.
In this study, we investigated 100cases of urinary stones for CT densityand stone composition analysis by FTIR.
f the received 100 samples, 71 were received from male patients, 29 from female patients,71 were renal stones, 25 were Ureteric stones, 4 were bladder stones .
According to KUB the density of urinary stones as found in this study 27 stones were heavy Radiopaque, 36 were radiopaque, 26 (26%) were radio faint and 11 were radiolucent .
With analysis of the stones in the study with FTIR 54% were mixed and 46% were pure .
13 urinary stones were Ca Oxalate Monohydrate stones, 18 stones are Ca Oxalate Dihydrate stones, 12 stones are CaOx/Ca Phospate stones,30 stones are Ca Oxalate and uric acid, 4 stones are Cysteine stones,12 stones are Stuvite stones (Mg+Ammonium+Phosphate) and 11 stones were Uric acid stones.
Predictors of stone composition
We studied the following factors as predictors of stone composition:
1.Sex
In the study 16 COMH stones found in males and 2 stones found in females, 8 CODH stones found in males and 5 stones found in females, 8 CaOx/CaPhosphate stones (8%) found in males and 4 stones (4%) found in females, 24
CaOx/Uric acid sto
nes (24%) found in males and 6 stones (6%)found in females, 2
Cystine stones (2%) found in males and 2 stones (2%)found in females,7 struvite stones (Mg Ammonium Phosphate) (7%) found in males and 5 stones (5%)found in females and 6 uric acid stones (6%)found in males and 5 stones (5%)found in females with p.value 0.25
SUMMARY AND CONCLUSION
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2.Stone site
According to the site of stone in this study COMH stones 1 found in the bladder,15 found in the kidney and 2 in the ureter, CODHstones 1 found in the bladder, 11 found in the kidney and 1 in the ureter ,CaOx/CaPhosphatestones 6 found in the kidney
and 6 in the ureter , CaOx/Uric acid stones 2 found in the bladder, 16 found in the kidney and 12 in the ureter, Cystine stones 3 found in the kidney and 1 in the ureter, Struvite stones (Mg Ammonium Phospate)10 found in the kidney and 2 in the ureter and Uric acid stones 10 found in the kidney and 1 in the ureter with p.value 0.173
3.Stone size in mm
According to the size of the stones in mm COMH stones were (mean±SD in mm 22.7± 6.8), CODH stones were (mean±SD in mm 27.2 ± 11.5), CaOx/CaPhosphate stones were (mean±SD in mm 18.5 ± 8.8), CaOx/Uric acid stones were (mean±SD in
mm 19.1 ± 9.8), Cystine stones were (mean±SD in mm 22.8 ±13.8), MgAmmonium Phospate stones were (2mean±SD in mm 15.8±7.8), Uric acid stones were (mean±SD in mm 24.3±12.3)
4.Kub density
In that study on KUB there were 12 COMH stones were heavy radiopaque and 6 stones were radiopaque ,5CODH stones were heavy radiopaque and 8 stones were radiopaque, 3 Caox/ Caphosphate stones were heavy radiopaque , 7 stones were radiopaque and 2stones were radiofaint,7 CaOx/Uric acid stones were heavy radiopaque,13 stones were radiopaque and 10 stones were radiofaint ,2 Cystine stones were radiofaint and 2 stones were radiolucent,2 MAP stones were radiopaque and 10 were radiofaint and uric acid stones in the study there was 2 stones radiofaint and 9 stones were radiolucent with p.value <0.001
5.CT density
The relation of composition of stones to the CT density (HU of stone) as resulted in our study is that COMH (mean±SD in HU 1380 ± 179), CODH (mean±SD in HU 1058± 141), CaOx/ Ca Phosphate (mean±SD in HU 969 ± 191), Cystine (mean±SD in HU 609 ±61), Mg Ammonium Phospate (mean±SD in HU 832 ± 138) and Uric acid (mean±SD in HU 400 ±100) with P. value of 0.001
In our study there was relation between the radioopacity in KUB and HU of thestone as Radiolucent stones (mean±SD 464± 24) , Radio faint stones (mean±SD 712± 150) ,Radiopaque stones(mean±SD 933±227) and Heavy Radiopaque stones (mean±SD 1246± 243) with p.value <0.001
IN our study our result was the ability of non-contrast C.T to detect stone composition is limited to uric acid and calcium oxalate mono hydrates stones. Despite limited ability it still can give good insight for further treatment and patient counseling.