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AJR 2004; 182:1039-1041
© American Roentgen Ray Society


Normal Ureter Size on Unenhanced Helical CT

Natalie Zelenko1, Deidre Coll2, Arthur T. Rosenfeld3 and Robert C. Smith4

1 Weill Medical College of Cornell University, 420 E 70th St., New York, NY 10021.
2 Department of Radiology, New York-Presbyterian Hospital, 525 E 68th St., New York, NY 10021.
3 Department of Diagnostic Imaging, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510.
4 Fordham University School of Law, 140 W 62nd St., New York, NY 10023.

OBJECTIVE. Unenhanced helical CT is the imaging method of choice when evaluating patients with acute flank pain and suspected ureterolithiasis. In addition to directly identifying stones in the lumen of the ureter, CT secondary signs of obstruction such as ureteral dilatation are frequently present and can be helpful in establishing a diagnosis. The purposes of this study were to define ureteral dilatation on unenhanced helical CT and determine the range of normal ureter size.

MATERIALS AND METHODS. We retrospectively reviewed the unenhanced helical CT studies of 212 consecutive patients with acute flank pain whose CT scans showed acute ureterolithiasis. The size of the ureter was determined on the asymptomatic side as well as on the obstructed side. Mean ureteral diameter was determined as the largest transverse dimension along the course of the ureter beginning 1–2 cm below the ureteropelvic junction.

RESULTS. The mean size of ureters on the asymptomatic side was 1.8 mm with a standard deviation (SD) of 0.9 mm. The mean size of ureters on the obstructed side was 7 mm with an SD of 3.2 mm. In 96% of patients, the ureter diameter on the asymptomatic side was 3 mm or smaller.

CONCLUSION. Three millimeters should be considered the upper limit of normal size for nonobstructed ureters on unenhanced helical CT.


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