CT of kidney stone disease

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Author: Mikael Häggström [notes 1]

Planning

Evaluation

File:CT measurement of kidney stone in soft tissue and bone window.jpg
Measurement of a 5.6 mm large kidney stone in soft tissue window (at left, with width of 400 HU, and center at 50 HU) versus skeletal window (right, W1800,C400). 145 HU is regarded as an appropriate cutoff to distinguish stone from surrounding tissue.[2]

Proper sizing of a stone is important at around 5 mm and above, since smaller stones generally pass spontaneously.[note 1] Sizing of larger stones is also important in order to decide which treatment to choose.[note 2]

Notes

  1. ↑ Ureteric stones less than 5 mm in diameter pass spontaneously in up to 98% of cases, while those measuring 5 to 10 in diameter pass spontaneously in less than 53% of cases.
    - Gettman, MT; Segura, JW (2005). "Management of ureteric stones: Issues and controversies ". British Journal of Urology International 95 (Supplement 2): 85–93. doi:10.1111/j.1464-410X.2005.05206.x. PMID 15720341. 
  2. ↑ Small proximal ureteral calculi of less than 10 mm are best treated with shock wave lithotripsy and ureteroscopy, while those larger than 10 mm are best treated with flexible ureteroscopy combined with holmium laser lithotripsy.
    - Glenn M Preminger, Section Editors:Stanley Goldfarb, Michael P O'Leary. Deputy Editor:Albert Q Lam (2018-01-19). Management of ureteral calculi. UpToDate.

References

  1. ↑ Smith-Bindman, Rebecca; Aubin, Chandra; Bailitz, John; Bengiamin, Rimon N.; Camargo, Carlos A.; Corbo, Jill; Dean, Anthony J.; Goldstein, Ruth B.; et al. (2014). "Ultrasonography versus Computed Tomography for Suspected Nephrolithiasis ". New England Journal of Medicine 371 (12): 1100–1110. doi:10.1056/NEJMoa1404446. ISSN 0028-4793. 
  2. ↑ Lidén, Mats; Thunberg, Per; Broxvall, Mathias; Geijer, Håkan (2015). "Two- and three-dimensional CT measurements of urinary calculi length and width: a comparative study ". Acta Radiologica 56 (4): 487–492. doi:10.1177/0284185114528490. ISSN 0284-1851. 


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