Objective To investigate the clinical application of CT-ultrasound image fusion (fusion ultrasound)-guided precise puncture of renal calyx dome in percutaneous nephrolithotomy (PCNL) for patients with mild hydronephrosis and renal calculi. Methods A retrospective analysis was conducted on 88 patients with mild hydronephrotic renal calculi who underwent PCNL treatment at the Department of Urology of Anhui Provincial Corps Hospital of Chinese People's Armed Police Force from April 2024 to February 2026. The patients were divided into a fusion ultrasound group (n=40) and a control group (n=40) based on different puncture guidance methods. The fusion ultrasound group used CT-ultrasound image fusion technique to precisely locate and puncture the renal calyx dome to establish a percutaneous access tract, while the control group relied on conventional two-dimensional ultrasound and the experience of the operators for puncture. The number of puncture attempts, tract establishment time, surgical duration, intraoperative blood loss, primary stone clearance rate, postoperative hospitalization stay, postoperative hemoglobin and serum creatinine levels, and complication rates were compared between the two groups. Results The fusion ultrasound group showed significantly fewer puncture attempts, shorter tract establishment time, shorter surgical duration, less intraoperative bleeding, and shorter postoperative hospitalization compared to the control group. Hemoglobin levels were significantly higher in the fusion ultrasound group than in the control group (P<0.05), while there was no statistically significant difference in serum creatinine levels between the two groups. The primary stone clearance rate was 87.50% in the fusion ultrasound group, significantly higher than 68.75% in the control group (P<0.05). The postoperative complication rate was 7.50% in the fusion ultrasound group, significantly lower than 22.91% in the control group. All differences were statistically significant (P<0.05). Conclusions Targeted puncture of the renal calyx dome using CT-ultrasound image fusion in PCN for patients with mild hydronephrotic renal calculi demonstrates high overall safety and efficacy, which can effectively improve the puncture success rate and primary stone clearance rate, shorten the operation and hospitalization duration, and reduce the intraoperative bleeding and postoperative complications.
Key words
percutaneous nephrolithotomy /
computed tomography /
ultrasound-image fusion technique /
renal calculi /
hydronephrosis
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