Learning objectives
To elaborate the imaging findings that need to be reported to help surgeons make an appropriate management strategy for renal stones.
Background
Urolithiasis is a common disease worldwide and affects various population groups, irrespective of race or geographic boundaries.In the past few decades, there has been an increasing incidence of urinary stone disease both in developed and developing nations due to changes in life style.[1] Appropriate management of renal stones is important as it can lead to complications such as sepsis, chronic kidney disease leading to renal failure.
DECT improves the characterization of renal stone by giving stone composition in addition to their basic identification, thereby tailoring...
Findings and procedure details
A single-energy low-dose non-contrast CT of the abdomen and pelvis was initially performed. Fig. 4 and Fig. 5
After identification of urinary tract on the raw CT data, stone targeted DECT was subsequently performed. Fig. 6 and Fig. 7
DECT was performed by targeted dual-energy scanning at two different energies of the anatomic region containing the stone and dual energy ratio for stone obtained.
Reporting renal stone on DECT should mention the below mentioned points which are required by referring surgeons to plan a holistic...
Conclusion
DECT has various advantages over other imaging techniques i.e. can be performed quickly, administration of contrast material is not required, can detect small sized stones, tells about stone composition and allows the detection of unsuspected extra-urinary and urinary abnormalities. Reporting of renal stones on DECT should include the afore mentioned salient points which will help referring doctor to come up with treatment formulated to individual patient’s needs. Radiologists have to remain up to date with recent advances to meet the expectations of treating surgeons.
Personal information and conflict of interest
A. Kanwar; New Delhi/IN - nothing to disclose S. Mehra; New Delhi/IN - nothing to disclose
References
Kambadakone A., Eisner B., Catalano O., Sahani D. New and evolving concepts in the imaging and management of urolithiasis: urologists’ perspective. Radiographics. 2010 May 4;30(3):603-23.
Heye T., Nelson R., Ho L., Marin D., Boll D. Dual-energy CT applications in the abdomen. Am J of Roentgenol. 2012 Nov;199(5_supplement):S64-70.
Hidas G., Eliahou R., Duvdevani M., Coulon P., Lemaitre L., Gofrit O. et al. Determination of renal stone composition with dual-energy CT: in vivo analysis and comparison with x-ray diffraction. Radiology. 2010 Nov;257(2):394-401.
Chaytor RJ, Rajbabu K, Jones...