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

  • Computed Tomography
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Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusion

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.

Key Points

• Unenhanced CT is now widely used to assess ureteric calculi.

• The same CT protocol can provide measurements of abdominal fat distribution.

• Ureteric calculi are usually treated by shock wave lithotripsy (SWL).

• Greater intra-abdominal fat stores are generally associated with poorer SWL results.

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Authors and Affiliations

  1. Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Hsu-Cheng Juan, Yii-Her Chou & Yung-Shun Juan

  2. Graduate Institute of Medicine, College of Medicine; Kaohsiung Medical University, Kaohsiung, Taiwan

    Hung-Yu Lin & Yung-Shun Juan

  3. Department of Urology, E-Da Hospital/ I-Shou University, Kaohsiung, Taiwan

    Hung-Yu Lin

  4. Institute of Oral Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan

    Yi-Hsin Yang

  5. Department of Radiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan

    Paul Ming-Chen Shih

  6. Department of Radiology, College of Medicine; Kaohsiung Medical University, Kaohsiung, Taiwan

    Paul Ming-Chen Shih

  7. Yuh-Ing Junior College of Health Care and Management, Kaohsiung, Taiwan

    Shu-Mien Chuang

  8. Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan

    Jung-Tsung Shen

  9. Department of Urology, Faculty of Medicine, College of Medicine; Kaohsiung Medical University, Kaohsiung, Taiwan

    Yung-Shun Juan

  10. No 100, Shih-Chuan 1st Road, Kaohsiung City, 807, Taiwan

    Yung-Shun Juan

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  1. Hsu-Cheng Juan
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Correspondence to Yung-Shun Juan.

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Juan, HC., Lin, HY., Chou, YH. et al. Abdominal fat distribution on computed tomography predicts ureteric calculus fragmentation by shock wave lithotripsy. Eur Radiol 22, 1624–1630 (2012). https://doi.org/10.1007/s00330-012-2413-6

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  • DOI: https://doi.org/10.1007/s00330-012-2413-6

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