Modern opportunities of the software processing of the computed tomography results in the planning of patient’s treatment with staghorn nephrolithiasis

Modern opportunities of the software processing of the computed tomography results in the planning of patient’s treatment with staghorn nephrolithiasis

Alexandrova K.A., Rudenko V.I., Serova N.S., Pesegov S.V., Kapanadze L.B.

Purpose.

To evaluate the clinical significance of computer simulation and CT perfusion in improving the results of patients treatment with coral nephrolithiasis.

Materials and methods. In order to evaluate the clinical value of 3D - computer simulation in improving the results of treatment of patients with staghorn nephrolithiasis (SN), the analysis of examination and treatment of 143 patients with K2-K4 was carried out. The group of patients with 3D - modeling was 71 patients (49.6%), the control group of 72 patients (50.4%) with standard clinical examination. Retrospectively, the frequency of intra - and postoperative complications (bleeding, etc.), as well as the frequency of residual stones were analyzed.

To assess the value of kidney CT perfusion, to improve the treatment outcomes of patients with staghorn nephrolithiasis (SN), an analysis of the complex examination and treatment of 18 patients with coral stones was carried out. Studies were carried out on the apparatus Aquilion One 640 (Canon, Japan) in the volumetric mode, with a slice thickness of 0.5 mm, in the mode of soft-tissue reconstruction. All patients underwent CT perfusion followed by the construction of perfusion maps at the workstation to measure the perfusion parameters of the cortical and medulla of the kidney before and after surgical treatment to assess the parameters of renal blood flow.

Results. When analyzing the structure of treatment methods, depending on the use of computer modeling of the pathological process, there is an increase in the total share of the effectiveness of endoscopic aids as monotherapy by 12.34% compared with the control group of patients with a standard examination, which proved the importance of studying the topographic-anatomical structure of the kidney in combination with pathological process on a three-dimensional digital model when planning an intervention A study of kidney CT perfusion with monitoring changes in perfusion indices in the pre- and postoperative periods has shown itself to be an effective method for monitoring the recovery of renal function.

Conclusion. Computer modeling and evaluation of renal perfusion make it possible to prevent intra-and postoperative complications, to predict the result of surgical treatment, to quantify the functional state of the kidneys, as well as the degree and nature of urinary tract obstruction.

I.M. Sechenov First

Moscow State Medical University

Moscow, Russia

 

Keywords: urolithiasis, coral-like nephrolithiasis, the structure of the pelvis-pelvic system, angioarchitecture of the kidney, percutaneous nephrolithotripsy, combined treatment, multispiral computed tomography, perfusion, kidney function, contrast agent.


Corresponding author:  Alexandrova K.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Alexandrova K.A., Rudenko V.I., Serova N.S., Pesegov S.V., Kapanadze L.B. Modern opportunities of the software processing of the computed tomography results in the planning of patient’s treatment with staghorn nephrolithiasis. REJR 2019; 9(2):133-140. DOI:10.21569/2222-7415-2019-9-2-133-140.

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Received:        13.05.19 Accepted:       14.06.19