Abdominal fat distribution on computed tomography predicts ureteric calculus fragmentation by shock wave lithotripsy

作者：Juan Hsu Cheng; Lin Hung Yu; Chou Yii Her; Yang Yi Hsin; Shih Paul Ming Chen; Chuang Shu Mien; Shen Jung Tsung; Juan Yung Shun^*

来源：European Radiology, 2012, 22(8): 1624-1630.

DOI：10.1007/s00330-012-2413-6

• Computed tomography
• Ureteric calculus
• Shock wave lithotripsy
• Visceral fat area
• subcutaneous fat area

To assess the effects of abdominal fat on shock wave lithotripsy (SWL). We used pre-SWL unenhanced computed tomography (CT) to evaluate the impact of abdominal fat distribution and calculus characteristics on the outcome of SWL. %26lt;br%26gt;One hundred and eighty-five patients with a solitary ureteric calculus treated with SWL were retrospectively reviewed. Each patient underwent unenhanced CT within 1 month before SWL treatment. Treatment outcomes were evaluated 1 month later. Unenhanced CT parameters, including calculus surface area, Hounsfield unit (HU) density, abdominal fat area and skin to calculus distance (SSD) were analysed. %26lt;br%26gt;One hundred and twenty-eight of the 185 patients were found to be calculus-free following treatment. HU density, total fat area, visceral fat area and SSD were identified as significant variables on multivariate logistic regression analysis. The receiver-operating characteristic analyses showed that total fat area, para/perirenal fat area and visceral fat area were sensitive predictors of SWL outcomes. %26lt;br%26gt;This study revealed that higher quantities of abdominal fat, especially visceral fat, are associated with a lower calculus-free rate following SWL treatment. Unenhanced CT is a convenient technique for diagnosing the presence of a calculus, assessing the intra-abdominal fat distribution and thereby helping to predict the outcome of SWL. %26lt;br%26gt;aEuro cent Unenhanced CT is now widely used to assess ureteric calculi. %26lt;br%26gt;aEuro cent The same CT protocol can provide measurements of abdominal fat distribution. %26lt;br%26gt;aEuro cent Ureteric calculi are usually treated by shock wave lithotripsy (SWL). %26lt;br%26gt;aEuro cent Greater intra-abdominal fat stores are generally associated with poorer SWL results.

• 出版日期2012-8
• 单位河北医科大学