Abstract：
The stone density (SD) is not the same in all parts of the stone due to the heterogeneous nature of the stone and the shock wave (SW) passes through tissues of many different densities until it reaches the stone. These factors affect the success of Extracorporeal Shock Wave Lithotripsy (ESWL). We aimed to evaluate the effect of the Variation Coefficient of Stone Density (VCSD) and Renal Cortical Tickness (RCT) on the success of ESWL. Between 2020 and 2023, 510 patients who underwent ESWL were divided into 2 groups treatment success (n:304) and treatment failure (n:206). Non-Contrast Computed Tomography (NCCT) imaging values of hydronephrosis degree of the kidney, stone location, stone volume (SV), stone-skin distance (SSD), SD, Standard deviation of Stone Density (SDSD), VCSD, RCT, Soft-Tissue Thickness (STT), Muscle Thickness (MT) were analyzed. VCSD value was obtained by dividing SDSD by SD. Along the SW, tissues were divided into three components: kidney (renal cortex), muscle and other soft tissues. RCT, MT and SSD were measured at three different angles (0°, 45°, and 90°) and these 3 lengths were averaged. In univariate analysis, Body Mass Index (BMI), SV, SD, VCSD, SSD, RCT and STT were demonstrated to affect ESWL success. In multivariate analysis, low BMI, SV, SD, RCT and large VCSD were significant independent predictors of ESWL success. Among these parameters, VCSD had the highest prediction accuracy, followed by SD, SV, RCT and BMI, respectively. This study demonstrated that VCSD value and RCT are predictive parameters in determining the treatment of patients with urinary calculi and selecting suitable ESWL candidates.
摘要：
由于石头的异质性，石头的所有部分的石头密度（SD）都不相同，冲击波（SW）穿过许多不同密度的组织，直到到达石头。这些因素影响体外冲击波碎石术（ESWL）的成功。我们旨在评估结石密度变异系数（VCSD）和肾皮质斜度（RCT）对ESWL成功的影响。在2020年至2023年之间，将510名接受ESWL的患者分为2组治疗成功（n：304）和治疗失败（n：206）。肾积水程度的非对比计算机断层扫描（NCCT）成像值，石头位置,石头体积（SV），石皮距离（SSD），SD,石材密度的标准偏差（SDSD），VCSD,RCT,软组织厚度(STT),分析肌肉厚度(MT)。通过将SDSD除以SD获得VCSD值。沿着SW，组织分为三个组成部分：肾（肾皮质），肌肉和其他软组织。RCT,MT和SSD在三个不同的角度(0°，45°,和90°），并对这3种长度进行了平均。在单变量分析中，身体质量指数(BMI),SV,SD,VCSD,SSD,RCT和STT被证明会影响ESWL的成功。在多变量分析中，低BMI,SV,SD,RCT和大VCSD是ESWL成功的重要独立预测因子。在这些参数中，VCSD的预测精度最高，其次是SD，SV,RCT和BMI,分别。这项研究表明，VCSD值和RCT是确定尿路结石患者治疗方法和选择合适的ESWL候选人的预测参数。
