Farhana Riyaz, Rizwana Rehman Bazai, Saba Akram.
Diagnostic Accuracy of Non-Enhanced Computed Tomography in Determining the Outcome of Extra-Corporeal Shock Wave Lithotripsy for Urinary Calculi.
Pak J Med Health Sci Jan ;12(3):1283-5.

Aim: To determine the diagnostic accuracy of non-enhanced computed tomography in determining the success of extra-corporeal shock wave lithotripsy. Methods: This cross-sectional survey was conducted at Department of Diagnostic Radiology, The Children’s Hospital, Lahore in collaboration with the Department of Urology, Jinnah Hospital, Lahore from 15th February, 2014 to 15th August, 2014. All patients were collected from Urology Outdoor department, The Children’s Hospital, Lahore. All patients had to do NECT before EWSL, CT is conducted with 3 mm continuous axial sections through the renal calculus, using the soft tissue setting of window width 250-300 HU and window level of 40 HU at 120 KV and 165 mA. Attenuation value of Calculus was taken in Hounsfield units and all patients were divided according to calculus attenuation values as (1) calculus having density ≤945 HU and (2) calculus having density >945 HU. All patients were undergone ESWL (Storz Medical Modulith SLX-F2). A maximum of 6.0 KV was given to each patient, starting at 0.5 KV and rising slowly stepwise following every 20 shock waves. Total six sessions were given, each after 15 days interval. During each ESWL session up to 3000 shock waves were given. Results: Out of 180 patients, 91 (50.6%) were males and 89 (49.4%) were females with male to female ratio was 1:1.02. The mean +/- standard deviation of age was 13.15+/-1.74 years. The sensitivity and specificity were 95% and 52.6% while PPV and NPV were 94.4% and 55.5% respectively. Overall diagnostic accuracy was 90.5%. Conclusion: Renal calculus is an emergency condition in urology. Quick and timely mediation can save the life of patient and prevent complications like chronic renal failure.

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