Abstract
Using 18 domestic pigs, we investigated the value of real-time sonography for the determination of renal lesions immediately and 3 weeks after extracorporeal shock wave lithotripsy (SWL) on a lithotripter with electromagnetic shock wave generation. All animals were treated under general anesthesia with 2000 shock waves at 40 MPa. Eight animals (Group 1) were sacrificed after the ultrasound examination. Ten animals (Group 2) had a sonographic reexamination after 3 weeks and were sacrificed thereafter. Axial slices of the kidney specimens were prepared, and the presence and location of hematoma were noted. In Group 1 (acute damage), ultrasound showed renal damage in six kidneys. According to the histopathologic findings, six ultrasound studies were correct, one was false-positive, and one was false-negative. In Group 2, nine kidneys showed pathologic findings by ultrasound immediately after SWL. At 3-week reexamination, only one was still abnormal, but this kidney showed no renal hemorrhage on histopathologic study. In three of the histologic specimens, residual evidences of renal bleeding were seen that had not been detected by sonography. Acute renal damage after SWL can be assessed by ultrasound, whereas the smaller lesions that may still be present a few weeks later can be missed sonographically.
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