Non-contrast computed tomography characteristics in a large cohort of cystinuria patients
| Autor: | Kay Thomas, Rohit Srinivasan, Daniel Poon, Kerushan Thomas, Giles Rottenberg, Matthew Bultitude, Hannah Warren |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Nephrology
Adult Male medicine.medical_specialty Adolescent Genotype Urology 030232 urology & nephrology Cystine Contrast Media Computed tomography Cohort Studies 03 medical and health sciences chemistry.chemical_compound Young Adult 0302 clinical medicine Median follow-up Internal medicine Hounsfield scale medicine Humans Hounsfield units Aged Aged 80 and over Cystinuria medicine.diagnostic_test business.industry Attenuation Middle Aged medicine.disease Large cohort chemistry 030220 oncology & carcinogenesis Cohort Original Article Female Urinary Calculi Nuclear medicine business Tomography X-Ray Computed CT |
| Zdroj: | World Journal of Urology |
| ISSN: | 1433-8726 0724-4983 |
| Popis: | Purpose Cystine stones are widely considered hard and difficult to treat. Hounsfield Units (HU) are used in other stone types to estimate ‘hardness’ and treatments based on that finding. Our objective was to report mean HU of cystine stones in vivo in a large case series of cystinuria patients and assess for differences in genotype. Methods A prospective case series of cystinuria patients referred to a specialist centre was analysed. CT imaging was assessed by two independent radiologists to determine in vivo attenuation of cystine calculi. Mean HU was compared for both cystinuria genes (SLC3A1 and SLC7A9) using an independent t-test. Results 164 adult cystinuric patients were identified (55% male), median age 43 years (range 18–80). Median follow up was 31 months (IQR 10–62). Genetic data available for 153/164 (93%) demonstrated 97 SLC3A1 (63%) and 55 (36%) SLC7A9 mutations (39 homozygous, 16 heterozygous) and one heterozygous for both SLC3A1/SLC7A9. 107 patients had CT images available demonstrating calculi. Median HU across the cohort was 633 (5th to 95th centile 328–780). There was no difference in mean HU between SLC3A1 and SLC7A9 genotypes (p = 0.68) or homo and heterozygous SLC7A9 (p = 0.70). Mean HU correlated with stone size (Pearson correlation coefficient = 0.51, p Conclusion In this large single centre cystinuria cohort, mean HU was low for stones that are difficult to treat. Calculi of 1000 are unlikely pure cystine, and in a known cystinuric would suggest conversion to another stone type. |
| Databáze: | OpenAIRE |
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