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
Conclusion
Our study showed that the intravenous administration of iodinated contrast media in abdominal CT does not preclude the detection of renal stones,
especially those that are more clinically important.
Contrast-enhanced abdominal CT,
irrespective of the phase that it is performed (CMP or NGP),
can reliably detect (98%) renal stones measuring 6mm or more,
meaning that stones with a higher risk of not passing spontaneously can be safely diagnosed [6,7].
Furthermore,
a high proportion (82-88%) of smaller stones (3-5mm) is confidently seen after the intravenous administration of contrast media.
Kawamoto et al [1] evaluated the detectability of renal stones on arterial phase.
They showed that all stones larger than 5mm and 75% of all renal stones can be detected on the arterial phase,
suggesting that patients with acute abdominal pain may benefit from the use of CE-MDCT.
The percentage of stone detection according to our study was higher in the arterial phase than in Kawamoto's study.
This might be due to technological advances during the last decade.
A more recent study performed by Dym et al in 2014 [4] investigated the sensitivity of CE-MDCT in portal venous phase.
They concluded that CE-MDCT is highly sensitive for the detection of renal stones larger than or equal to 3mm in diameter.
In their study,
the sensitivity for renal stones ≥ 3mm was 95% and for renal stones ≥ 5mm 98%.
The result of that study is more consistent with our result.
To the best of our knowledge,
our study is the first study comparing the arterial and venous phases.
Contrast-enhanced abdominal CT,
due to its high detection rate of renal stones,
should be considered the examination of choice in patients presenting to the emergency department with colicky flank pain in order to avoid delay in the diagnosis of other more important diseases.