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Tanidir Y, Sahan A, Asutay MK, Sener TE, Talibzade F, Garayev A, Tinay I, Sekerci CA, Simsek F. Differentiation of ureteral stones and phleboliths using Hounsfield units on computerized tomography: a new method without observer bias. Urolithiasis 2016; 45:323-328. [PMID: 27638519 DOI: 10.1007/s00240-016-0918-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/03/2016] [Indexed: 12/25/2022]
Abstract
To differentiate ureteral stones and phleboliths by measuring density [as Hounsfield unit (HU)] and volume (as mm3) of the opacities in the bony pelvis on unenhanced computerized tomography (U-CT). A total of 52 patients, who underwent semirigid ureteroscopy and laser lithotripsy for distal ureteral stone and had isochoronous phleboliths in U-CT, were included. Images were reviewed for density and volume of the opacities. Data were compared, and a cut-off value was defined with receiver operating characteristics curve analysis to differentiate the nature of the opacity. Using the cut-off values of 171 mm³ for volume (sensitivity 75 %, specificity 100 %) and 643 HU for density (sensitivity 75 %, specificity 93 %), differentiation between stone and phlebolith was achieved. Differentiation of pelvic opacities needs meticulous observation with certain signs on U-CT. On the other hand, our study offers a new method, with certain cut-off values, such as 643 HU and 171 mm3, which can be used to precisely predict the actual nature of opacities of interest.
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Affiliation(s)
- Yiloren Tanidir
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey.
- Marmara Universitesi Pendik Egitim ve Arastırma Hastanesi, Fevzi Cakmak Mah., Mimar Sinan Cad. 41, Ust Kaynarca, Pendik, 34899, Istanbul, Turkey.
| | - Ahmet Sahan
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Mehmet Kazim Asutay
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Tarik Emre Sener
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Farhad Talibzade
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Asgar Garayev
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ilker Tinay
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Cagri Akin Sekerci
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ferruh Simsek
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
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