Tolga KARAKAN, Emre HURİ, İlkan TATAR, Hakan Hamdi ÇELİK, Akif DİRİ, Murat BAĞCIOĞLU, Cankon GERMİYANOĞLU

Üriner Sistem Taşlarının Mikrofokus Bilgisayarlı Tomografi ile Ultrastrüktürel Yapısının Analizi ve Kimyasal Analizle Karşılaştırılması

Amaç: Mikro bilgisayarlı tomografi (MCT) yöntemiyle üriner sistem taşlarının non- destruktif olarak ultrastrüktürel yapısının incelenmesi ve kimyasal analiz ile karşılaştırılması amaçlanmıştır Yöntemler: Bu çalışma Ankara Eğitim ve Araştırma Hastanesinde etik kurul onamını takiben yapıldı. Perkutan nefrolitotomi sırasında 30 hastadan çıkarılan intakt taşlar çalışmaya dahil edildi. Taşlar MCT ve takiben kimyasal analiz yöntemleriyle analiz edildi. Bulgular: Kimyasal analiz ile elde edilen taş komponentleriyle MCT ile tespit edilen taş komponentleri arasında bire-bir uyum değerlendirildiğinde uyum oranının istatistiksel olarak çok düşük olduğu görülmüştür (p<0,001). MCT yöntemine göre taşların içerdiği her bir bileşen yönünden taşın üç boyutlu (3D) yapısının homojen veya heterojen olma sıklığında istatistiksel olarak anlamlı değişimin olmadığı görülmüştür. Tek ve çoklu içeriğe sahip olan taşlar arasında taşın üç boyutlu yapısının homojen/heterojen olma sıklığında ve içerdikleri havada boşluk olup olmaması oranlarında istatistiksel olarak anlamlı farklılık bulunmamıştır (p>0,05). Ayrıca taşın üç boyutlu yapısıyla içeriğinin homojen ya da heterojen olması arasında bağlantı saptanamamıştır. Sonuç: Mikro bilgisayarlı tomografi ile taş analizinin oldukça zaman alıcı ve çok yüksek maliyetli bir yöntem olduğu görülmektedir. Bu yöntemin taş oluşum mekanizmaları ve gelecekte yapılabilecek tedavi yöntemlerine faydası olabileceği düşünülmektedir.

Anahtar Kelimeler:

Bilgisayarlı tomografi, mikro, üriner taş analizi, ürolitiyazis

Ultrastructural Analysis of Urinary Stones by Microfocus Computed Tomography and Comparison with Chemical Analysis

Objective: To investigate the ultra-structure of urinary system stones using micro-focus computed tomography (MCT), which makes non-destructive analysis and to compare with wet chemical analysis. Methods: This study was carried out at the Ankara Training and Research hospital. Renal stones, removed from 30 patients during percutaneous nephrolithotomy (PNL) surgery, were included in the study. The stones were blindly evaluated by the specialists with MCT and chemical analysis. Results: The comparison of the stone components between chemical analysis and MCT, showed that the rate of consistence was very low (p<0.001). There was no significant relationship between the components of stone and its heterogeneity or homogeneity. No significant difference was found between the stones with single component and those with multiple components in terms of its 3D structure being homogenous or heterogeneous and the presence of voids (p>0.05). It was also seen that there was no significant relation between its 3D structure being heterogeneous or homogenous. Conclusion: The stone analysis with MCT is a time consuming and costly method. This method is useful to understand the mechanisms of stone formation and an important guide to develop the future treatment modalities.

Keywords:

Computed tomography, micro, urinary stone analysis, urolithiasis,

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