Study on the lithotripsy efficiency of CT three-dimensional reconstruction-assisted flexible ureteroscopic litho-tripsy

LI Mao-sheng; LI Xing-bin; DENG Chun-hua; TANG Hao-tong; LIANG Chen

doi:10.13820/j.cnki.gdyx.20234016

Abstract：Objective To investigate the impact of kidney stone physical characteristics obtained through CT three-dimensional reconstruction on the efficiency of flexible ureteroscopic lithotripsy(FURL).Methods A total of 86 patients with kidney stones who met the inclusion criteria were selected from West China Airport Hospital of Sichuan Uni-versity between July 2021 and December 2022.The physical characteristics of the kidney stones,including number(units),length(mm),density(Hu),volume(cm3),and mass(Hu*cm3),were measured using CT three-dimen-sional reconstruction technology before surgery.All patients underwent FURL.Post-FURL,the patients were divided in-to a stone clearance group and a stone residual group based on the stone clearance status.Multifactorial binary logistic re-gression analysis was used to identify the influencing factors of the stone clearance rate after FURL.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of each stone characteristic for stone clearance af-ter FURL.The correlation between each stone characteristic and operation time was analyzed using the Spearman correla-tion coefficient.Results There were 67 cases in the stone clearance group and 19 cases in the stone residual group,with a stone clearance rate of 77.9％.Multivariate analysis showed that stone length,density,volume,and mass were inde-pendent risk factors affecting the stone clearance rate after FURL(P＜0.05).ROC curves showed that the area under the curve(AUC)for stone length,density,volume,and mass were 0.891,0.674,0.919,and 0.957,respectively,with stone mass having a significantly higher predictive efficiency for stone clearance than the other characteristics.The Spearman correlation coefficient indicated that stone length,density,volume,and mass were positively correlated with op-eration time(r=0.521,0.226,0.573,0.611,P＜0.05),with stone mass showing the highest correlation with opera-tion time.Conclusion Stone length,density,volume,and mass obtained through CT three-dimensional reconstruction are all risk factors affecting the treatment of kidney stones by FURL.Among these,stone mass,as an indicator of stone burden,can better predict the lithotripsy efficiency of FURL in treating kidney stones.