Abstract:
PURPOSE:Burst wave lithotripsy (BWL) is a transcutaneous technique with potential to safely and effectively fragment renal stones. Preclinical investigations of BWL require the assessment of potential renal injury. This study evaluates the capabilities of real-time ultrasound and MRI to detect and evaluate BWL injury that was induced in porcine kidneys. MATERIALS AND METHODS:Ten kidneys from five female farm pigs were treated with either a 170 or 335 kHz BWL transducer using variable treatment parameters and monitored in real-time with ultrasound. Eight kidneys were perfusion fixed and scanned with a 3-Tesla MRI scanner (T1-weighted, T2-weighted, and susceptibility-weighted imaging), followed by processing via an established histomorphometric technique for injury quantification. In addition, two kidneys were separately evaluated for histologic characterization of injury quality. RESULTS:Observed B-mode hyperechoes on ultrasound consistent with cavitation predicted the presence of BWL-induced renal injury with a sensitivity and specificity of 100% in comparison to the histomorphometric technique. Similarly, MRI detected renal injury with a sensitivity of 90% and specificity of 100% and was able to identify the scale of lesion volumes. The injuries purposefully generated with BWL were histologically similar to those formed by shock wave lithotripsy. CONCLUSIONS:BWL-induced renal injury can be detected with a high degree of sensitivity and specificity by real-time ultrasound and post-treatment ex vivo MRI. No injury occurred in this study without cavitation detected on ultrasound. Such capabilities for injury detection and lesion volume quantification on MRI can be used for preclinical testing of BWL.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
May PC,Kreider W,Maxwell AD,Wang YN,Cunitz BW,Blomgren PM,Johnson CD,Park JSH,Bailey MR,Lee D,Harper JD,Sorensen MDdoi
10.1089/end.2017.0202subject
Has Abstractpub_date
2017-08-01 00:00:00pages
786-792issue
8eissn
0892-7790issn
1557-900Xjournal_volume
31pub_type
杂志文章abstract:: Introduction and Objective: Current available lithotrites have clinical stone clearance rates averaging 24 to 32 mm2/minute. The objective of this study was to critically evaluate the initial experience with the Swiss LithoClast ® ...
journal_title:Journal of endourology
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abstract:PURPOSE:To compare blind access and totally tubeless percutaneous antegrade removal and pneumatic transurethral ureterolithotripsy for the management of impacted upper-ureteral calculi >1 cm. PATIENTS AND METHODS:Seventy patients (41 male, 29 female) with impacted upper-ureteral calculi >1 cm were selected in randomiz...
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journal_title:Journal of endourology
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abstract::Seventy-four consecutive cases of ureteral stones listed for ureteroscopic lithotripsy were studied prospectively. In all cases, the Wolf 7.5F or 9F ureteroscope was used in conjunction with the Swiss Lithoclast system. Dormia baskets were employed on four occasions to prevent forward propulsion of fragments. Ureteros...
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