Keywords:
Kidney, Abdomen, Contrast agents, CT, Contrast agent-intravenous, Calcifications / Calculi
Authors:
A. M. C. Odenrick, N. Kartalis, N. Voulgarakis, F. Morsbach, L. Loizou; Stockholm/SE
DOI:
10.1594/ecr2018/C-1535
Aims and objectives
Nephrolithiasis is a common disorder with a reported incidence of 12% in industrialized countries [1] and is globally increasing [2].
Colicky flank pain is the most common presenting symptom of obstructive urolithiasis [2].
Previous studies have shown that even renal stones that do not cause obstruction still may cause flank pain and that in the absence of a separate cause,
either clinical or evident on CT,
these stones are likely to be the cause of the symptoms [3,4,5].
Non-contrast (NC) multidetector computed tomography (MDCT) of the abdomen and pelvis has been considered the method of choice for renal stone detection [4,6-10].
The reason the examination is carried out without intravenous contrast is based on the theory that the high attenuating stone will be difficult to detect during either the corticomedullary (CMP) or nephrographic phase (NGP) when the surrounding renal parenchyma also enhances and becomes high attenuating [4].
It is known that other renal diseases such as infections and neoplasms,
and even extrarenal diagnoses such as diverticulitis,
appendicitis,
pelvic inflammatory disease and malignancies can simulate renal colic [4,8].
In those cases,
avoiding intravenous contrast may lead to wrong or delayed diagnosis.
A previous study showed that when a NC-MDCT is performed because of flank pain,
up to one-third of the cases show unsuspected findings that are not related to stone disease [8].
The purpose of this study was to investigate the detectability of renal stones in CMP and NGP.