Secondary fındıngs of ureteral stones and theır relatıonshıp wıth stone sıze ın unenhanced computed tomography (original) (raw)
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Characterization of Renal Stones by Computed Tomography and Ultrasound
This study aimed to evaluate the role of ultrasound(U/S) versus spiral Computed Tomography (CT) in the diagnosis of urinary system calculi. This study was conducted in the Department of Radiology in ALamal Hospital in Khartoum State, in the period ranged (August 2011-December 2011, included 50 subjects (35 males (70%) and 15 females (30%)), their ages range from 15 to 72 years old with symptoms of renal stones They were selected from patients who had been referred for CT KUB and U/S in ALamal hospital.Spiral CT and U/S were done for all cases .this study showed that The most affected age group ranged from 21-40 years old 56 %, most patients were affected in the both sides, with no history of renal stones in their families most of the stones lodged in the kedneys (36%) and at the ureters (8%). It can be said that the two image modalities were performed together and used as essential techniques of renal stones, which help to obtain accurate diagnosis and demonstrate any changes that can affect urinary systems by stones.
Radiological Study on the Anatomical Site and Size of Ureteric Calculi: A Retrospective Study
INTERNATIONAL JOURNAL OF ANATOMY RADIOLOGY AND SURGERY
ntroduction: Ureteric stones are said to lodge most commonly at the narrowest anatomical areas of the ureter. The site of pain depends on the location of the calculi. Spontaneous passage of ureteric stones is influenced by size, location and laterality of the stones. Aim: To investigate the size and location of ureteric stones. Materials and Methods: This was a retrospective study of 72 patients in whom urinary stones were diagnosed by computed tomography between January 2018 and July 2019. The size of the ureteric stones was measured by its maximal width on Computed Tomography (CT) and location of the stones was also determined. The diameter of both the ureters were ascertained at the widest portion. Statistical analysis was performed using SPSS version 23. Descriptive data was presented as percentage and mean while comparative analysis was done using Student’s t-test. Results: The average patient age was 41±12.4 years (range, 17- 70 years) affecting 42 (58.33%) males and 30 female...
Radiology, 2016
Purpose To determine if a reduced-dose computed tomography (CT) protocol could effectively help to identify patients in the emergency department (ED) with moderate to high likelihood of calculi who would require urologic intervention within 90 days. Materials and Methods The study was approved by the institutional review board and written informed consent with HIPAA authorization was obtained. This was a prospective, single-center study of patients in the ED with moderate to high likelihood of ureteral stone undergoing CT imaging. Objective likelihood of ureteral stone was determined by using the previously derived and validated STONE clinical prediction rule, which includes five elements: sex, timing, origin, nausea, and erythrocytes. All patients with high STONE score (STONE score, 10-13) underwent reduced-dose CT, while those with moderate likelihood of ureteral stone (moderate STONE score, 6-9) underwent reduced-dose CT or standard CT based on clinician discretion. Patients were...
Ureterorenoscopy, a review of first three years of experience for ureteric stone disease
The Professional Medical Journal, 2019
Objectives: Ureterorenoscopy is a diagnostic and therapeutic modality, used for different ureteral and renal pathologies. It has virtually replaced open surgery for ureteric calculi. Study Design: Observational. Setting: Urology Department of Sargodha Medical College, Sargodha. Period: 2011-2015. Material and Methods: All cases who underwent URS for stone disease during the study period were included in the study. The initial criterion was a bit strict, due to minimum experience, which limited only clinically fit patients with no co-morbid illnesses, with stone size of 1 cm or less, located in middle or preferable in distal ureter, single stone was also preferred, but later the criterion was relaxed with gain confidence. The procedures were performed under general anesthesia using R Wolf Ureterorenoscope. Results: The total number of cases included in the study were 332 of which 189 were males and 143 were females. Average age being 42.82 years. The total number of stones managed we...
European Radiology, 2019
Objectives To evaluate the influence of the urinary bladder volume on the detectability of urolithiasis at the ureterovesical junction (UVJ) using a low-dose CT (LD-CT) with iterative reconstruction (IR) and a standard-dose CT (SD-CT) without IR in a large cohort. Methods Four hundred patients (278 males (69.5%), mean 44.6 ± 14.7 years) with urolithiasis at the UVJ were investigated either by an LD-CT with IR (n = 289, 72%) or an SD-CT without IR (n = 111, 28%) protocol. The detectability of distal urolithiasis was assessed by a dichotomous assessment (definite or questionable) by two radiologists in consensus and by a quantitative analysis of the signal density distribution across a line drawn parallel to the distal ureter. Based on the resulting graph, minimum/maximum density values and mean/maximum upslopes and downslopes were derived and calculated automatically. In all patients, the total bladder volume was calculated by a slice-by-slice approach on axial CT images. Results Patients with definite stones showed significantly higher urinary bladder volumes compared to patients with questionable stones in both LD-CT and SD-CT (p < 0.01). These results were independent of stones' length and patients' BMI values. Using cutoffs of 92 ml for LD-CT and 69 ml for SD-CT, high positive predictive values/accuracy rates of 96%/85% (LD-CT) and 98%/ 86% (SD-CT) were observed to identify definite urinary stones. Conclusions Urinary bladder volume has a significant impact on the detectability of distal urolithiasis. Moderate bladder filling by pre-CT hydration with subsequent CT scan at the time of high urge to void increases the detectability of urinary stones at the UVJ in clinical routine. Key Points • Urinary bladder volume significantly affects the detectability of distal urolithiasis • Higher bladder volumes are associated with improved detectability of distal urinary stones • Oral pre-CT hydration for urolithiasis is easily applicable and cost-effective
Accuracy of Sonography for Detection of Renal Stone Comparison with Non-Enhanced Computed Tomography
Introduction: Renal or ureteric calculi are a common incidental finding on abdominal imaging. In most cases no definite cause is identified and the natural cumulative recurrence rate is reported to be 14% at 1 year, 35% at 5 years and 52% at 10 years. Many factors, including race, diet, occupation and water hardness have been implicated in stone formation. In most cases a definite cause is not identified but certain predisposing factors are recognized. Non enhanced helical computed tomography (CT) has become the primary imaging modality for evaluating acute flank pain and suspected renal stone disease. Ultrasound has an important role in the diagnosis and management of urinary tract stones but it has its limitations. The safety and ease of the ultrasound examination are unsurpassable, but its accuracy is modest. Reported sensitivities range from 37 to 64% for calculus detection and 74 to 85% for the detection of acute obstruction. Depending on its composition, a renal stone can be either sound transmitting or so reflective that only its near surface is seen as echogenic cap. Objectives: To determine the sensitivity and specificity of ultrasonography (US) for detecting parenchymal and renal pelvis calculi and to establish the accuracy of US for determining the size and number of calculi, and to find the correlation between the accuracy of sonography with stone size. Patients & method: This is a prospective study conducted from October 2015 to May 2016. Fifty patients (23 men and 27 women) with a mean age of 40 years (range, 19–69 years) selected from Consultant Clinic of Urology of Baghdad Teaching Hospital who had acute flank pain, hematuria or dysuria, and suspected renal stone. Ultrasound was performed by using Philips HD 11 EX equipped with (3.5 MHz) Convex Transducer with High Resolution Monitor and a Thermal Page Printer, Real Time B-Mode Gray Scale and the Examination consist of either dedicated Renal or Abdominal imaging. Non-Enhanced CT scans were performed with (4-chnannel multidetector spiral CT unit [ Toshiba Aquilion , model TSX-101A ] , 5.0 mm slices with 1.0 pitch , 5.0 mm collimation , 120 kv , (200-360) m As this was changed by the operator according to the patient size. Results: Of the 50 patients, 36 (72 %) had a total 105 renal stones identified on Nonenhanced CT scans. Mean stone size (long axis) was 4.5 mm ± 0.5 with a range of (1.1 – 25 mm), Of these 36 patients, 20 (55 %) had multiple renal stones with mean stone size 3.8 mm ± 0.3 (size range 1.4 – 25 mm). Ultrasound demonstrate 50 of 105 renal stones identified on CT images, 16 stones in the Small size group (0.0-3.0mm), 19 stones in the Medium size group (3.1-7.0mm) and 15 stones in Large size group (>7.0mm). Conclusion: US is of limited value for detecting renal stones.CT is the gold standard for assessing the size, number, and location of renal stones.
Unenhanced computed tomography findings of renal papillae in patients with a ureteral stone
Clinical & Investigative Medicine, 2016
Purpose: In some patients with a ureteral stone without uretero-hydronephrosis, it is difficult to determine the location of the stone. The objective of the present study was to investigate the changes in renal papillae using unenhanced computerized tomography (uCT) and determine the side of calculi using the renal papillary findings in patients with a ureteral stone. Methods: uCT data from 81 patients were retrospectively reviewed for this study. The inclusion criteria were unilateral ureteral calculi, no renal calculi and no hydronephrosis. For each patient, three measurements of CT attenuation of 0.05 cm2 area were made in the tip of the interested renal papillae, both stone side and non-stone side. Student’s t test was used for statistical analysis. Results: Forty-one right-sided and 40 left- sided isolated unilateral ureteral calculi patients were evaluated by uCT exam. The average attenuations of the tip of the papillae in stone side and non-stone side were 34.1 Hounsfield uni...
Clinical Radiology, 2013
Urolithiasis is a common disease with a reported prevalence between 4% and 20% in developed countries. Determination of urinary calculi composition is a key factor in preoperative evaluation, treatment, and stone recurrence prevention. Prior to the introduction of dual-energy computed tomography (DECT), available methods for determining urinary stone composition were only available after stone extraction, and thereby unable to aid in optimized stone management prior to intervention. DECT utilizes the attenuation difference produced by two different x-ray energy spectra to quantify urinary calculi composition as uric acid or non-uric acid (with likely further classification in the future) while still providing the information attained with a conventional CT. Knowledge of DECT imaging pitfalls and stone mimics is important, as the added benefit of dual-energy analysis is the determination of stone composition, which in turn affects all aspects of stone management. This review briefly describes DECT principles, scanner types and acquisition protocols for the evaluation of urinary calculi as they relate to imaging pitfalls (inconsistent characterization of small stones, small dual-energy field of view, and mischaracterization from surrounding material) and stone mimics (drainage devices) that may adversely impact clinical decisions. We utilize our clinical experience from scanning over 1200 patients with this new imaging technique to present clinically relevant examples of imaging pitfalls and possible mechanisms for resolution.