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Asonic Imaging for Extracorporeal Shockwave Lithotripsy: Analysis of Factors in Successful Treatment
Author(s) -
KIELY E. A.,
MADIGAN D.,
RYAN P. C.,
BUTLER M. R.
Publication year - 1990
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1990.tb14888.x
Subject(s) - supine position , medicine , extracorporeal shockwave lithotripsy , lithotripsy , extracorporeal , ultrasound , ultrasonography , surgery , radiology
Summary The emergence of real‐time ultrasonic imaging for extracorporeal Shockwave lithotripsy poses questions regarding the factors and techniques which facilitate stone imaging for clinicians with no previous practical experience in ultrasonography. The ability of these clinicans to assess when stone disintegration has been achieved also needs to be confirmed. A wide range of data was recorded from each of 2688 lithotripsy treatments performed over a 2‐year period using the EDAP LT.01 ultrasound‐imaged piezoelectric lithotriptor. An analysis of these data was performed using a comprehensive microcomputer‐based statistics package. The mean time taken for stone imaging and positioning was reduced from 11.2 to 7.5 min over the 2‐year period. Obese patients and those with renal pelvic stones were best imaged in a lateral position. Overall there was no difference in percentage stone disintegration or clearance between treatments in the supine or lateral positions, but a significant reduction in the clearance of small caliceal stones resulted when the lateral position was used. Factors associated with a significantly greater percentage of stone disintegration and clearance included pain experienced by the patient during fine adjustment of the processing head during treatment, acoustic focus attenuation and widening and acoustic shadow widening as detected by the urologist at the end of treatment. Among the factors not associated with significant alterations in the percentage of stone disintegration or clearance were the lithotriptor operator, the side or site of the calculus, obesity and Shockwave frequency or power. This study confirmed the ability of urologists to develop expertise in ultrasonography for renal stone imaging and to interpret successfully the subtle signs of stone disintegration.