Ureterolithiasis: can clinical outcome be predicted with unenhanced helical CT?

Abstract

PURPOSE:

To evaluate the use of helical computed tomography (CT) without contrast material enhancement for prediction of a favorable outcome in ureterolithiasis.

MATERIALS AND METHODS:

CT studies were reviewed in 69 patients with a single ureteral stone not located at the ureteropelvic junction. CT findings (tissue rim sign, hydronephrosis, perinephric fat stranding, perinephric fluid collections, and thickening of renal fascia) were graded on a scale of 0-3. Stone diameter and renal parenchymal enlargement were also measured.

RESULTS:

Twenty-two patients had spontaneous passage, 12 did not respond to conservative treatment, and 35 were lost to follow-up. When the latter 35 patients were excluded, perinephric fat stranding (P = .044) and perinephric fluid collections (P = .021) were graded significantly higher in patients with spontaneous stone passage. Mean stone diameter was significantly larger (P < .001) in patients in whom conservative treatment failed (mean, 7.8 mm) than in patients with spontaneous stone passage (mean, 2.9 mm). The presence of a tissue rim sign and the grade of hydronephrosis, renal fascial thickening, and renal parenchymal enlargement were not significantly different between the two groups.

CONCLUSION:

In addition to stone size, the degree of perinephric fat stranding and the presence of perinephric fluid collections are useful ancillary signs for help in predicting the likelihood of stone passage.

• Authors: N Takahashi, A Kawashima, R D Ernst, I C Boridy, S M Goldman, G S Benson, C M Sandler
• Journal: Radiology (Radiology) Vol. 208 Issue 1 Pg. 97-102 (Jul 1998) ISSN: 0033-8419 [Print] United States
• PMID: 9646798 (Publication Type: Journal Article)

Topics

• Adipose Tissue (diagnostic imaging)
• Adolescent
• Adult
• Evaluation Studies as Topic
• Exudates and Transudates
• Fascia (diagnostic imaging)
• Female
• Follow-Up Studies
• Forecasting
• Humans
• Hydronephrosis (diagnostic imaging)
• Image Processing, Computer-Assisted
• Kidney (diagnostic imaging)
• Male
• Middle Aged
• Predictive Value of Tests
• Radiographic Image Enhancement
• Remission, Spontaneous
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods)
• Treatment Outcome
• Ureteral Calculi (diagnostic imaging, therapy)