Low-Dose Unenhanced Multidetector CT of Patients with Suspected Renal Colic
Denis Tack1,
Stavroula Sourtzis1,
Isabelle Delpierre1,
Viviane de Maertelaer2 and
Pierre Alain Gevenois3
1 Department of Radiology, Centre Hospitalier Universitaire de Charleroi,
Hôpital Civil de Charleroi, 92 blvd. Janson, B-6000-Charleroi,
Belgium.
2 Statistical Unit, Institut de Recherche Interdisciplinaire en Biologie Humaine
et Nucléaire, Université Libre de Bruxelles, Brussels,
Belgium.
3 Department of Radiology, Hôpital Erasme, Université Libre de
Bruxelles, Brussels, Belgium.
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Fig. 1A. —Low-dose unenhanced multidetector CT scans obtained with 4
x 2.5 mm collimation at 120 kVp in 45-year-old man (body mass index,
41.7 kg/m2) with acute left flank pain. Axial image acquired with
30 mAs at level of kidneys shows left perirenal stranding (arrowhead)
and mild hydronephrosis (arrow). These indirect signs of stone
migration were seen by all reviewers during all interpretation sessions.
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Fig. 1B. —Low-dose unenhanced multidetector CT scans obtained with 4
x 2.5 mm collimation at 120 kVp in 45-year-old man (body mass index,
41.7 kg/m2) with acute left flank pain. Axial image obtained at 30
mAs at level of ureteropelvic junction shows ring artifact
(arrow).
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Fig. 1C. —Low-dose unenhanced multidetector CT scans obtained with 4
x 2.5 mm collimation at 120 kVp in 45-year-old man (body mass index,
41.7 kg/m2) with acute left flank pain. Axial image obtained at 60
mAs, reconstructed at same level as A, was acquired because reviewers
were unable to interpret image obtained at 30 mAs (B) and asked for
images obtained at 60 mAs. Ureteral calcification (arrow) close to
left ureteropelvic junction was identified by all reviewers.
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Fig. 2A. —Low-dose unenhanced multidetector CT scans obtained with 4
x 2.5 mm collimation at 120 kVp in 38-year-old woman (body mass index,
23.5 kg/m2) with right acute flank pain. Axial image obtained at 30
mAs at level of right kidney shows no secondary renal signs.
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Fig. 2B. —Low-dose unenhanced multidetector CT scans obtained with 4
x 2.5 mm collimation at 120 kVp in 38-year-old woman (body mass index,
23.5 kg/m2) with right acute flank pain. Axial image obtained at 30
mAs at level of ureteropelvic junction shows calcification (arrow)
corresponding to phlebolith close to right ureteropelvic junction. This image
was correctly diagnosed by reviewers A and B, who are experienced in
interpreting CT, but not by reviewer C (resident with 1 year of experience)
during first session. Reviewer C diagnosed this image correctly during second
interpretation session.
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Fig. 2C. —Low-dose unenhanced multidetector CT scans obtained with 4
x 2.5 mm collimation at 120 kVp in 38-year-old woman (body mass index,
23.5 kg/m2) with right acute flank pain. Axial image obtained at 60
mAs, reconstructed at same level as B was not needed by any reviewer.
Calcification (arrow) corresponding to phlebolith close to right
ureteropelvic junction was visible as in B.
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Fig. 3. —Low-dose unenhanced multidetector CT scan obtained with 4
x 2.5 mm collimation at 120 kVp and 30 mAs in 29-year-old man who was
obese (body mass index, 34.4 kg/m2) with acute left flank pain. Curved
multiplanar reformation including left dilated ureter from left kidney to
bladder shows ureteral stone (arrow) in distal ureter.
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Copyright © 2003 by the American Roentgen Ray Society.
