Non-enhanced CT axis rotating movie imaging in percutaneous nephrolithotomy for complex renal calculi / 中华泌尿外科杂志

ABSTRACT

Objective To discuss the clinical application and significance of non-enhanced computed tomography axis rotating movie imaging technique in PCNL for complex renal calculi. Methods Thirty-one cases unilateral and 2 cases bilateral multiple and staghorn renal calculi with mild or mediurn hydronephrosis patients were performed bilateral kidneys non-enhanced CT scanning,three dimensional reconstruction and the axis rotating movie composition were carried on by computer software,PCNL accesses were designed and the residual stone were predicted referred to the access-calyces angle measured in axis rotating movie image,PCNL were performed after while.Comparing between preoperation accesses design and residual stone prediction with in-operation practice were carried out.Results The first PCNL access was constructed via posterior middle upper minor calyces in 22 renal units and via posterior middle lower minor calyces in 13 renal units,which was consistent with pre-operation design according to CT axis rotating movie image.The second PCNL accesses were constructed via lower calyx posterior upper minor calyces in 9 renal units and via lower calyx posterior lower minor calyces in 5 renal units,nephrolithotomy were performed in the same operation,clinical stone clearance rate was 80%(28/35),other 7 cases with residual stone were consistent with pre-operation prediction,No blood transfusion was necessary and no severe complication happened in all 33 cases.Conclusions Non-enhanced CT axis rotating movie imaging provided the detail three dimensional shape and spatial structure of complex renal calculi intuitively) that was benefit for designing appropriate PCNL accesses for complex renal calculi patients, guiding for searching stone fragments in operation, predicting residual stone, and ensuring operation safety.