The Structural Basis of Kidney Stone Fragility

肾结石脆性的结构基础

• 批准号: 7268738
• 负责人: JAMES C WILLIAMS
• 金额: $ 24.55万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7268738
• 关键词: 3-Dimensional; Accounting; Acids; Alternative Therapies; Appearance; Calculi; Canis familiaris; Class; Cleaved cell; Clinical; Cystine; Data; Diagnosis; Diagnostic; Exposure to; Felis catus; Goals; Guidelines; Human; Image; In Vitro; Injury; Invasive; Kidney; Kidney Calculi; Knowledge; Lead; Length; Lithotripsy; Location; Maps; Methods; Minerals; Mixed Stone; Nature; Numbers; Outcome; Patients; Pattern; Percutaneous Nephrostomy; Physicians; Predisposition; Procedures; Proteins; Reporting; Research; Resistance; Resolution; Scanning; Shock; Slice; Spiral Computed Tomography; Structure; Surface; Technology; Testing; To specify; Trauma; Ureteroscopy; Uric Acid; Urinary Calculi; Urination; Urine; Urologist; Variant; Width; Work; X-Ray Computed Tomography; analytical tool; attenuation; base; experience; three dimensional structure

DESCRIPTION (provided by applicant): Shock wave lithotripsy (SWL) of kidney stones is not always successful. Stones in a significant percentage of patients fail to fragment completely. These patients may undergo more than one SWL session with no positive outcome, and then must be treated by an invasive procedure (e.g., percutaneous nephrostomy or ureteroscopy). Even when SWL is successful, the physician has no good guidelines to follow in determining how many SW's to administer, and patients may receive many more SW's than is required to break up the stone. If stone fragility could be predicted during diagnosis, the physician could select the best treatment, including the optimal number of SW's for SWL, or in the case of SW-resistant stones move to an alternative therapy. Helical computed tomography (CT) has the potential to help predict stone fragility. However, we lack sufficient knowledge about the structure of kidney stones to know the CT features that distinguish easy-to-break stones from those that are SW-resistant and should not be treated by SWL. Hypothesis: Urinary stones that are susceptible to lithotripter SW's can be distinguished radiologically from those stones that are SW-resistant. Plan: The proposed research will characterize fragility-relevant structures that are visible within kidney stones by mu CT. We will identify features (including mineral compositions and internal structures) that correlate with--and thus, can be used to predict-the susceptibility (or resistance) of stones to lithotripter shock waves, working through the following Specific Aims: 1. Calibrate micro computerized tomography (mu CT) imaging of urinary stones so that stones can be analyzed for composition and for three-dimensional structure using this non-destructive analytical tool. 2. Determine the degree to which similar stone analysis can be accomplished using present helical CT technology. 3. Determine if stone fragility in SWL correlates with CT-visible structure. 4. Determine if fragility in SWL for some stones might be determined by features below the resolution of CT. The long-term goal of this work is to enable the physician to predict the fragility of kidney stones at diagnosis so that the best treatment option can be chosen.

描述（由申请人提供）：肾结石的冲击波碎石（SWL）并不总是成功。 很大一部分患者中的石头无法完全分裂。 这些患者可能会进行多次SWL疗程，而没有阳性结果，然后必须通过侵入性手术（例如经皮肾术或输尿管镜检查）进行治疗。 即使SWL成功，医生也没有良好的指导方针来确定要管理多少SW，并且患者可能会收到比破坏石头所需的SW的更多指南。如果可以在诊断期间预测石材脆弱性，则医生可以选择最佳治疗方法，包括SWL的最佳疗法，或者在SW抗Sw的石头中移至替代疗法。 螺旋计算机断层扫描（CT）具有帮助预测石材脆弱性的潜力。 但是，我们对肾结石的结构缺乏足够的知识，无法了解将易于破坏的石头与耐SW的耐药结构区分开的CT特征，不应由SWL处理。 假设：容易受到岩性肌s的尿石可以在放射学上与SW抗抗毒物的那些石头区分开。 计划：拟议的研究将表征与MU CT在肾结石中可见的相关结构。 我们将确定与与岩石横梁冲击波的易感性（或抗性）相关的特征（包括矿物组成和内部结构），因此可以用来预测 - 易感性（或抗性），均通过以下特定目的进行工作： 1。校准尿石的微型计算机断层扫描（MU CT）成像，以便可以使用这种非破坏性分析工具分析石头的组成和三维结构。 2。确定使用当前的螺旋CT技术可以完成类似的石材分析的程度。 3。确定SWL中的石材脆弱性是否与CT可见结构相关。 4.确定某些石头中SWL中的脆弱性是否可以通过CT分辨率下方的特征来确定。 这项工作的长期目标是使医生能够预测诊断时肾结石的脆弱性，以便可以选择最佳的治疗选择。