Unenhanced multi-detector row CT in patients suspected of having urinary stone disease: effect of section width on diagnosis
- PMID: 15758192
- DOI: 10.1148/radiol.2352040448
Unenhanced multi-detector row CT in patients suspected of having urinary stone disease: effect of section width on diagnosis
Abstract
Purpose: To assess prospectively the effect of section width in multi-detector row computed tomographic (CT) evaluation of patients with acute flank pain who are suspected of having or known to have urinary stone disease.
Materials and methods: This study was approved by the ethics committee of the authors' university, and written informed consent was obtained from all patients. One hundred forty-seven patients (age range, 11-101 years; mean, 51.4 years +/- 18.7 [standard deviation]) suspected of having urinary stone disease underwent unenhanced multi-detector row CT. CT was performed with four detector rows, a section thickness of 1.0 mm, an effective tube current-time product of 100 mAs, and a tube voltage of 120 kVp (CT dose index, 11.4 mGy). From these data, three sets of transverse images were reconstructed with section widths of 1.5, 3.0, and 5.0 mm and approximately 50% of overlap each. Scans were evaluated in varying random orders by two radiologists for the number, size, and location of uroliths and nephroliths and for the presence of phleboliths, renal cysts, and secondary signs of obstruction. The significance of differences between the numbers of detected calcifications and the numbers of associated abnormalities on the scans obtained with varying section widths was tested with the McNemar test at a P level of less than .05. Spearman rho rank correlation coefficients were calculated to assess the correlation between the presence of uroliths and the presence of secondary signs.
Results: Uroliths were found in 72 of 147 (49.0%) patients, and nephroliths were found in 16 patients (10.9%). There was no significant difference between section widths of 1.5 and 3.0 mm with regard to the number of detected stones (264 uroliths and 61 nephroliths for both protocols). Transverse sections 5.0-mm wide revealed significantly fewer uroliths (n = 231; P < .001) and nephroliths (n = 47; P < .016). The final diagnosis was changed in four of 72 patients. All missed renal and ureteral stones measured less than 3 mm in diameter.
Conclusion: Overlapping 3-mm sections are sufficient for the detection of urinary stone disease. Small calculi (<3 mm) may be missed on 5.0-mm-thick sections.
(c) RSNA, 2005.
Similar articles
-
Low-dose and standard-dose unenhanced helical computed tomography for the assessment of acute renal colic: prospective comparative study.Acta Radiol. 2005 Nov;46(7):756-63. doi: 10.1080/02841850500216004. Acta Radiol. 2005. PMID: 16372698
-
Detection of urinary tract stones at low-radiation-dose CT with z-axis automatic tube current modulation: phantom and clinical studies.Radiology. 2005 May;235(2):523-9. doi: 10.1148/radiol.2352040331. Epub 2005 Mar 15. Radiology. 2005. PMID: 15770037
-
Helical CT for nephrolithiasis and ureterolithiasis: comparison of conventional and reduced radiation-dose techniques.Radiology. 2003 Nov;229(2):575-80. doi: 10.1148/radiol.2292021261. Epub 2003 Oct 2. Radiology. 2003. PMID: 14526095
-
[Unenhanced spiral CT in urolithiasis: indication, performance and interpretation].Rofo. 2003 Jul;175(7):904-10. doi: 10.1055/s-2003-40426. Rofo. 2003. PMID: 12847644 Review. German.
-
Unenhanced helical CT in the investigation of acute flank pain.Clin Radiol. 2002 Jun;57(6):435-41. doi: 10.1053/crad.2001.0871. Clin Radiol. 2002. PMID: 12069457 Review.
Cited by
-
Automatic Urinary Stone Detection System for Abdominal Non-Enhanced CT Images Reduces the Burden on Radiologists.J Imaging Inform Med. 2024 Apr;37(2):444-454. doi: 10.1007/s10278-023-00946-2. Epub 2024 Jan 10. J Imaging Inform Med. 2024. PMID: 38343222 Free PMC article.
-
Does unenhanced computerized tomography as imaging standard post-retrograde intrarenal surgery paradoxically reduce stone-free rate and increase additional treatment for residual fragments? Outcomes from 5395 patients in the FLEXOR study by the TOWER group.Ther Adv Urol. 2023 Sep 8;15:17562872231198629. doi: 10.1177/17562872231198629. eCollection 2023 Jan-Dec. Ther Adv Urol. 2023. PMID: 37701535 Free PMC article.
-
Practices and utility of imaging among urological communities for urolithiasis, observations, and inferences from a targeted survey.Urolithiasis. 2023 Jul 25;51(1):97. doi: 10.1007/s00240-023-01471-1. Urolithiasis. 2023. PMID: 37490149
-
A deep learning system for automated kidney stone detection and volumetric segmentation on noncontrast CT scans.Med Phys. 2022 Apr;49(4):2545-2554. doi: 10.1002/mp.15518. Epub 2022 Feb 22. Med Phys. 2022. PMID: 35156216 Free PMC article.
-
Pediatric stone disease: Current management and future concepts.Turk Arch Pediatr. 2021 Feb 3;56(2):99-107. doi: 10.5152/TurkArchPediatr.2021.20273. eCollection 2021 Mar. Turk Arch Pediatr. 2021. PMID: 34286317 Free PMC article. Review.
MeSH terms
LinkOut - more resources
Full Text Sources