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Helical CT for Nephrolithiasis and Ureterolithiasis: Comparison of Conventional and Reduced Radiation-Dose Techniques¹

¹ From the Department of Radiology, Duke University Medical Center, Durham, NC. From the 2002 RSNA scientific assembly. Received October 8, 2002; revision requested December 17; revision received January 27, 2003; accepted March 10. Address correspondence to J.P.H., Department of Radiology, Waterford Regional Hospital, Waterford, Ireland (e-mail: heneghanj@sehb.ie).

View larger version (123K): [in a new window]   Figure 1a. (a) Transverse unenhanced helical single-detector row CT scan obtained with 170 mA (136 mAs) and pitch of 1.5 demonstrates left pelvicaliectasis (arrow). (b) Repeat scan obtained at 100 mA (80 mAs) clearly demonstrates left pelvicaliectasis (arrow).

View larger version (126K): [in a new window]   Figure 1b. (a) Transverse unenhanced helical single-detector row CT scan obtained with 170 mA (136 mAs) and pitch of 1.5 demonstrates left pelvicaliectasis (arrow). (b) Repeat scan obtained at 100 mA (80 mAs) clearly demonstrates left pelvicaliectasis (arrow).

View larger version (109K): [in a new window]   Figure 2a. (a) Transverse unenhanced multi-detector row CT scan obtained at 220 mA (176 mAs) and pitch of 0.75 (4 x 5-mm detector configuration) demonstrates a 5-mm-diameter proximal left ureteral calculus (arrow). (b) Repeat scan obtained at 100 mA (80 mAS) also demonstrates the left ureteral calculus (arrow).

View larger version (111K): [in a new window]   Figure 2b. (a) Transverse unenhanced multi-detector row CT scan obtained at 220 mA (176 mAs) and pitch of 0.75 (4 x 5-mm detector configuration) demonstrates a 5-mm-diameter proximal left ureteral calculus (arrow). (b) Repeat scan obtained at 100 mA (80 mAS) also demonstrates the left ureteral calculus (arrow).

View larger version (136K): [in a new window]   Figure 3a. (a) Transverse unenhanced multi-detector row CT scan obtained at 220 mA (176 mAs) and pitch of 0.75 (4 x 5-mm detector configuration) demonstrates right pelvicaliectasis (arrow) and perinephric fluid (arrowhead). (b) Repeat multi-detector row CT scan obtained at 100 mA (80 mAS) demonstrates right pelvicaliectasis (arrow), although the perinephric fluid (arrowhead) is not readily discerned.

View larger version (146K): [in a new window]   Figure 3b. (a) Transverse unenhanced multi-detector row CT scan obtained at 220 mA (176 mAs) and pitch of 0.75 (4 x 5-mm detector configuration) demonstrates right pelvicaliectasis (arrow) and perinephric fluid (arrowhead). (b) Repeat multi-detector row CT scan obtained at 100 mA (80 mAS) demonstrates right pelvicaliectasis (arrow), although the perinephric fluid (arrowhead) is not readily discerned.

View larger version (118K): [in a new window]   Figure 4a. (a) Transverse unenhanced multi-detector row CT scan obtained at 210 mA (168 mAs) and pitch of 0.75 (4 x 5-mm detector configuration) demonstrates right ureteral dilatation (arrow). (b) Repeat scan obtained with 100 mA (80 mAs) demonstrates right ureteral dilatation (arrow).

View larger version (123K): [in a new window]   Figure 4b. (a) Transverse unenhanced multi-detector row CT scan obtained at 210 mA (168 mAs) and pitch of 0.75 (4 x 5-mm detector configuration) demonstrates right ureteral dilatation (arrow). (b) Repeat scan obtained with 100 mA (80 mAs) demonstrates right ureteral dilatation (arrow).

View larger version (55K): [in a new window]   Figure 5. Chart depicts the mean agreement (in percentages, shown as numbers at tops of bars) averaged over three independent readers for findings of renal calculi (ren calc), ureteral calculi (ur calc), obstruction (obst), or other abnormalities (other abn). Agreement is depicted for standard- versus reduced-dose scans (black bars), standard-dose scans alone (gray bars), and low-dose scans alone (white bars).

View larger version (118K): [in a new window]   Figure 6a. Images in a 55-year-old man with left-sided pain. (a) Transverse unenhanced single-detector row CT scan obtained with 170 mA (136 mAs) and pitch of 1.5 demonstrates fat stranding around sigmoid diverticula (arrow), a finding that is consistent with diverticulitis. (b) Repeat CT scan obtained with 100 mA (80 mAs) demonstrates inflammatory changes in the left lower quadrant (arrow).

View larger version (123K): [in a new window]   Figure 6b. Images in a 55-year-old man with left-sided pain. (a) Transverse unenhanced single-detector row CT scan obtained with 170 mA (136 mAs) and pitch of 1.5 demonstrates fat stranding around sigmoid diverticula (arrow), a finding that is consistent with diverticulitis. (b) Repeat CT scan obtained with 100 mA (80 mAs) demonstrates inflammatory changes in the left lower quadrant (arrow).

View larger version (32K): [in a new window]   Figure 7. Graph shows comparison of effective dose equivalent from standard- and reduced-dose scans obtained with both single-detector row (CT/i) and multi-detector row (QX/i) CT. Numbers at tops of bars are values from the x axis. low = reduced dose, std = standard dose.