ObjectiveTo investigate the clinical value of calculi atomic number and CT value determined by energy spectrum CT in evaluating the efficacy of extracorporeal shock wave lithotripsy(ESWL) for upper urinary tract calculi. MethodsA total of 450 patients with solitary urinary calculi between 2010 and 2013 were enrolled as group A, and underwent ESWL after definite diagnosis by ultrasound or X ray. A total of 1050 patients with solitary urinary calculi between 2014 and February, 2017 were enrolled as group B. Definite diagnosis, atomic number measurement and composition analysis of calculi were conducted using energy spectrum CT in group B, then 100 cases with friable calculi were screened out and underwent ESWL. The success rate of one-time lithotripsy was compared between the two groups. ResultsThe success rate one-time lithotripsy was 76.0%（342/450）in group A . In group B, the cases with friable calculi were screened accprding to the atomic number by energy spectrum CT. Of 100 cases with the components of uric acid, ammonium magnesium phosphate or calcium oxalate dihydrate stones, uric acid calculi was found in 11 cases, magnesium ammonium phosphate calculi in 29 and calcium oxalate dihydrate calculi in 60 cases. The success rate one-time lithotripsy was (87/100) in group B. Significant difference in the success rate of one-time lithotripsy was observed between the two groups(P＜0.05). ConclusionThe atomic number and CT value of calculi can effectively determine the composition of calculi. The renal organic and functional damage caused by aimless lithotripsy can be avoided if the ESWL can be performed after screening of the cases with friable calculi. Moreover, the efficacy of ESWL can be improved, the cost of treatment can be saved and the therapeutic time can be shortened.

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