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. 2015 Jan;43 Suppl 1(0 1):13-7.
doi: 10.1007/s00240-014-0702-z. Epub 2014 Aug 6.

Micro-CT imaging of Randall's plaques

James C Williams Jr  1 , James E Lingeman, Fredric L Coe, Elaine M Worcester, Andrew P Evan
Affiliations

Micro-CT imaging of Randall's plaques

James C Williams Jr et al. Urolithiasis. 2015 Jan.

Abstract

Micro-computed tomographic imaging (micro-CT) provides unprecedented information on stone structure and mineral composition. High-resolution micro-CT even allows visualization of the lumens of tubule and/or vessels within Randall's plaque, on stones or in papillary biopsies, thus giving a non-destructive way to study these sites of stone adhesion. This paper also shows an example of a stone growing on a different anchoring mechanism: a mineral plug within the lumen of a Bellini duct (BD plug). Micro-CT shows striking structural differences between stones that have grown on Randall's plaque and those that have grown on BD plugs. Thus, Randall's plaque can be distinguished by micro-CT, and this non-destructive method shows great promise in helping to elucidate the different mechanisms by which small stones are retained in the kidney during the development of nephrolithiasis.

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Conflict of interest statement

Conflict of interest T he authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Micro-CT imaging of Randall’s plaque in human papillary biopsy. a Inset ureteroscopic image of papillary surface before biopsy. a X-ray image of biopsy. About 450 such images were taken, with the specimen rotated 0.4° between each image. This image series was used for tomographic reconstruction. b Reconstructed slice through the biopsy, with inset showing higher magnification of a small portion of Randall’s plaque within the tissue
Fig. 2
Fig. 2
Small calcium oxalate monohydrate stone, growing on Randall’s plaque. a Ureteroscopic view of stone (arrowhead) before removal. b Surface rendering of the 3D micro-CT image stack shows a relatively smooth stone surface (top) with some polyhedral calcium oxalate dihydrate (COD) crystals, but a ragged surface for the Randall’s plaque, which was pulled off the papilla tip. c Micro-CT image slice showing stone attached to plaque. Some lumens of tubules and/or vessels within the plaque are marked with arrows
Fig. 3
Fig. 3
Apatite stone growing on end of BD plug. a Photograph of stone, after removal, shown on mm-grid paper. b Surface reconstruction of stone, showing head of stone on top of apatite plug. c Micro-CT image slice, showing the distinct morphologies of the apatite portion that grew in the calyceal urine and the apatite that formed within the BD lumen
Fig. 4
Fig. 4
Randall’s plaque and BD plug, both composed of apatite, shown side by side. See text for details
See this image and copyright information in PMC

References

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