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Urinary Stone Disease: Comparison of Standard-Dose and Low-Dose with 4D MDCT Tube Current Modulation

¹ Department of Radiology, Heilig Hart Ziekenhuis, Mechelsestraat 24, B 2500 Lier, Belgium.
² Department of Urology, Heilig Hart Ziekenhuis, Lier, Belgium.

View larger version (153K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —23-year-old man (height, 1.79 m; weight, 89 kg; BMI, 27.78) with left-sided renal colic and microscopic hematuria. Standard-dose 6-MDCT examination with mean effective tube current of 93 mAs and calculated effective dose of 5.7 mSv. Axial 5-mm MDCT scan shows 1.1-cm stone (arrow) in left pyeloureteral junction.

View larger version (154K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —23-year-old man (height, 1.79 m; weight, 89 kg; BMI, 27.78) with left-sided renal colic and microscopic hematuria. Standard-dose 6-MDCT examination with mean effective tube current of 93 mAs and calculated effective dose of 5.7 mSv. Coronal 5-mm MDCT image shows obstructive large stone (arrow) depicted in A.

View larger version (152K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —40-year-old man (height, 1.80 m; weight, 92 kg; BMI, 28.4) with severe right-sided acute renal colic. Low-dose16-MDCT examination with mean effective tube current of 59 mAs and calculated effective dose of 1.53 mSv. Coronal 5-mm image shows 7-mm stone (arrow) in distal lumbar ureter and obstructive dilatation (asterisk) of more proximal portion of ureter.

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —25-year-old man (height, 1.78 m; weight, 104 kg; BMI, 32.82) with left-sided acute flank pain. Low-dose 16-MDCT examination with mean effective tube current of 66 mAs and effective dose of 1.72 mSv. Axial 5-mm MDCT image shows 1-mm distal stone (arrow) at junction of ureter with bladder.

View larger version (138K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —25-year-old man (height, 1.78 m; weight, 104 kg; BMI, 32.82) with left-sided acute flank pain. Low-dose 16-MDCT examination with mean effective tube current of 66 mAs and effective dose of 1.72 mSv. Coronal 5-mm MDCT image shows stone (arrow) depicted in A.

View larger version (155K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4 —34-year-old woman (height, 1.69 m; weight, 69 kg; BMI, 24.45) with left-sided acute flank pain. Low-dose 6-MDCT examination with mean effective tube current of 37 mAs and calculated effective dose of 1.77 mSv. Coronal 5-mm image shows small stone (solid arrow) at vesicoureteral junction, secondary renal obstruction (open arrow), and urinoma (asterisk).

View larger version (126K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5 —45-year-old man (height, 1.73 m; weight, 89 kg; BMI, 29.74) with left-sided flank pain. Standard-dose 6-MDCT examination at mean effective tube current of 79 mAs and calculated effective dose of 5.16 mSv. Coronal 5-mm image shows 2-mm ureteral stone (arrow) at intersection of ureter and iliac vessels that led to false-negative finding of small calcified atheromatous plaque.

View larger version (149K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6 —37-year-old woman (height, 1.62 m; weight, 84 kg; BMI, 32.01) with left-sided acute flank pain. Low-dose 6-MDCT examination with mean effective tube current of 52 mAs and calculated effective dose of 2.81 mSv. Coronal 5-mm image shows bilateral ovarian teratomas or dermoid cysts (asterisks) and larger, left teratoma compressing left pelvic ureter.

View larger version (140K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —24-year-old man (height, 1.79 m; weight, 75 kg; BMI, 23.41) with right-sided acute flank pain and macroscopic hematuria. Low-dose 16-MDCT examination with mean effective tube current of 44 mAs and calculated effective dose of 1.15 mSv. Coronal 5-mm MDCT image shows evidence of mass lesion (arrows) in region of calyces of upper pole of right kidney.

View larger version (155K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —24-year-old man (height, 1.79 m; weight, 75 kg; BMI, 23.41) with right-sided acute flank pain and macroscopic hematuria. Low-dose 16-MDCT examination with mean effective tube current of 44 mAs and calculated effective dose of 1.15 mSv. Coronal 5-mm conventional renal CT scan after IV administration of iodinated contrast material confirms presence of semisolid tumor mass (asterisk). Right nephrectomy was performed, and pathologic finding was carcinoma of collecting duct (Bellini's tubule).

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