الفهرس 
Gross Anatomy of KidneyOnly 14 pages are availabe for public view
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Abstract
Imaging of renal stones is an important diagnostic tool as well as
an initial step in deciding the therapeutic option to be used for
management.
CT of the abdomen and pelvis can be considered as the most
accurate diagnostic tool used to evaluate nephrolithiasis patients.
Unique radiographic characteristic of increased renal papillary
density was found in patients with kidney stones and this radiographic
finding supports the role of renal papillary deposits in the
pathophysiology of stone formation.
More recently a retrospective study demonstrated that increased
renal papillary Hounsfield density is associated with an increased future
risk of stones. However, the phenomenon of increased renal papillary
Hounsfield density in stone formers has not been studied with respect
to stone composition.
This study aimed to determine the difference in densities of renal
papillae in patients with stones compared to control subjects, using
attenuation measurements (HU) on Computed Tomography (CT) to
determine whether nephrolithiasis is associated with increased density
in renal papillae, or not.
This prospective case control study was carried out on 124
patients. They were further divided into two groups.Group1 (patient
group) included 62 stone formers patients, {34 males (54.8%) and 28
females (45.2%)}. The mean age was 38 years with age range from (24
to 60). group 2 (control group) included 62 age and gender matched
control subjects.
In this study age distribution of our patients revealed that
incidence of kidney stone disease commonly occured between age (30
-40) years old. There was no statistically significant difference
regarding the gender in stone forming patients.
In our patients the most commonly encountered clinical
presentation was loin pain (46.7 %), followed by dysuria (38.7%).
The main finding of this study was that there was highly
statistically significant difference (P<0.001) between the stone forming
patients and control group as regards renal papillae HU density of
upper, middle and lower calyces.
Also there were highly statistically significant difference
(P<0.001) between the non-stone bearing kidney in unilateral kidney
stone formers and control group regarding HU of renal papillae of
upper, middle and lower calyces.
While there were no statistically significant difference (P= 0.35)
between kidney with stone and kidney without stone in unilateral
kidney stone formers, according to HU of renal papillae of upper,
middle and lower calyces. This suggests that changes in the renal
papilla which result in elevated Hounsfield density measurements in
these patients occur in both kidneys, and not just in the calyx where the
calculus has formed.
Further large scale studies are necessary to confirm the obtained
results.