Shock wave induced histopathologic changes of the kidney tissue have been elucidated by light microscopy and transmission electron microscopy. These gross morphologic changes have been imaged by ultrasonography, computed tomography, and magnetic
resonance image. One to one correlation between pathologic and radiologic images, however, has not been made. It has been controversial that anticoagulants may augment hemorrhagic complication of shock wave exposure.
Shock waves were delivered to rabbit kidneys to correlate the pathologic and radiologic findings and to prove the effect of anticoagulants. 15 rabbits were experimented for this study and devided into three groups[Group A : no medication, Group B
:
intravenous injection of Hypaque(2ml/kg) prior to shock wave exposure, Group C : intravenous injection of Heparin(250unit/kg) prior to shock wave exposure].
Rabbit's right kidney was saved for control and only left kidney was targeted by shock wave. EDAP LT 02 piezoelectric extracorporeal shock wave lithotriptor was used and storage 20 and power 100% was set. Within one hour after complishment of
shock
wave
exposure, CT was performed and rabbits were sacrificed within 24 hours after CT examination.
The gross pathologic changes were mainly subcapsular hematoma and renal parenchymal hemorrhage. Light microscopic findings were various extent of parenchymal hemorrhage, tissue necrosis, tubular cast, and epithelial degeneration. Precontrast
CT(n=10)
depicted easily swelling,, contour bulging, and distortion of renal architecture. Postcontrast CT(n=5) not only defined those findings better but also showed additionally subcapusular hematoma and extravasated contrast media in renal parenchyma.
The
presence and absence of morphology changes were relatively well correlated between CT and gross pathologic examination but severity of tissue damages was not well correlated. There were no statistically significant differences in radiologic and
pathologic findings of renal injuries among three groups of anticoagulant regimen.
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