Central European journal of urology · 2017
Detection of early DJ-stent encrustation by sonographic twinkling-artifacts - a pilot study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Blaheta Roman A, Oertl Anton, Freisleben Hans-Joachim, Nelson Karen, Ackermann Hanns, Haferkamp Axel, Engl Tobias
Аннотация
INTRODUCTION: Ureter obstruction caused by a retro-peritoneal tumor is treated by inserting an indwelling ureter splint (DJ-stent). Indwelling duration is limited by cumulative crystalline deposits into the splint, eventually causing the repeated impairment of urine flow. Deciding when a DJ-stent must be replaced is important since belated removal can be accompanied by severe complications. X-ray or conventional sonography do not allow satisfactory evaluation of early incrustation, therefore, the use of sonographic twinkling artifacts (TA) to provide accurate stent surveillance was investigated.
MATERIAL AND METHODS: 26 patients with indwelling ureter splints carrying a high risk of developing tumor lysis syndrome (TLS), which is often accompanied by early splint incrustation, were investigated utilizing TA the day after DJ-stent implantation and weekly thereafter. Serum creatinine, uric acid, and urine pH were measured at all TA exams.
RESULTS: Early incrustation of the ureter splint was detected by TA in all patients 1-4 weeks after implantation. Incrustation occurred sooner with increased uric acid levels, and high creatinine or acidic urine accelerated early implant incrustation.
CONCLUSIONS: TA can be used to monitor early crystalline deposits in implanted ureter splints, before they can be detected by conventional sonography or X-ray imaging and before complications occur.
MATERIAL AND METHODS: 26 patients with indwelling ureter splints carrying a high risk of developing tumor lysis syndrome (TLS), which is often accompanied by early splint incrustation, were investigated utilizing TA the day after DJ-stent implantation and weekly thereafter. Serum creatinine, uric acid, and urine pH were measured at all TA exams.
RESULTS: Early incrustation of the ureter splint was detected by TA in all patients 1-4 weeks after implantation. Incrustation occurred sooner with increased uric acid levels, and high creatinine or acidic urine accelerated early implant incrustation.
CONCLUSIONS: TA can be used to monitor early crystalline deposits in implanted ureter splints, before they can be detected by conventional sonography or X-ray imaging and before complications occur.