Is Non-Contrast Computed Tomography Necessary in Younger Patients with Haematuria Enabling Stone Disease Diagnosis?: A 3-year Review of >12,000 CT Scans.
BAUS ePoster online library. Johnson H. 06/21/21; 319106; p6-8
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Mr. Hans Johnson
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Abstract
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Introduction:
Non-contrast Computed Tomography (NCCT) is the diagnostic benchmark for urinary stones. This study evaluates the diagnostic accuracy in detecting kidney/ureteric stones, including those patients presenting with haematuria.
Materials Methods:
Over 3 years; all CT scans of abdomen, pelvis, and urinary tract were reviewed. Clinical indications, radiological reports, patient demographics, diagnosis, and stone parameters were reviewed.
Results:
12,048 CT scans from 9,853 patients were reviewed. Median age was 56.4 years (range 16-96 years). >50% of the scans were undertaken for suspected renal colic. Only 41% of the patients suspected to have stones were confirmed on CT.
595 patients had incidental diagnosis of stone disease; more than 66.7% of these inpatients investigated for haematuria. In 2,651 patients with stone disease, 53% were renal stones and thrice more likely to be in the lower pole calyx. Half of the stone patients had multiple stones.
42% had ureteric stones. 66.7% of these patients had stone in the lower ureter and 25% in the upper ureter. Hydronephrosis was absent in 25% of the patients and mild renal pelvis dilatation reported in half of the group.
Conclusions:
NCCT remains the gold standard in diagnosing renal and ureteric stones. Positive predictive value for clinical diagnosis was 41%. 16% of stone patients had haematuria.
Half the stone patients had ureteric stones. Ultrasound would have failed to diagnose stones in 25% of patients and in half with only mild dilatation of the renal pelvis, suggesting the need for NCCT in patients <50 years with abdominal pain and haematuria.
Non-contrast Computed Tomography (NCCT) is the diagnostic benchmark for urinary stones. This study evaluates the diagnostic accuracy in detecting kidney/ureteric stones, including those patients presenting with haematuria.
Materials Methods:
Over 3 years; all CT scans of abdomen, pelvis, and urinary tract were reviewed. Clinical indications, radiological reports, patient demographics, diagnosis, and stone parameters were reviewed.
Results:
12,048 CT scans from 9,853 patients were reviewed. Median age was 56.4 years (range 16-96 years). >50% of the scans were undertaken for suspected renal colic. Only 41% of the patients suspected to have stones were confirmed on CT.
595 patients had incidental diagnosis of stone disease; more than 66.7% of these inpatients investigated for haematuria. In 2,651 patients with stone disease, 53% were renal stones and thrice more likely to be in the lower pole calyx. Half of the stone patients had multiple stones.
42% had ureteric stones. 66.7% of these patients had stone in the lower ureter and 25% in the upper ureter. Hydronephrosis was absent in 25% of the patients and mild renal pelvis dilatation reported in half of the group.
Conclusions:
NCCT remains the gold standard in diagnosing renal and ureteric stones. Positive predictive value for clinical diagnosis was 41%. 16% of stone patients had haematuria.
Half the stone patients had ureteric stones. Ultrasound would have failed to diagnose stones in 25% of patients and in half with only mild dilatation of the renal pelvis, suggesting the need for NCCT in patients <50 years with abdominal pain and haematuria.
Introduction:
Non-contrast Computed Tomography (NCCT) is the diagnostic benchmark for urinary stones. This study evaluates the diagnostic accuracy in detecting kidney/ureteric stones, including those patients presenting with haematuria.
Materials Methods:
Over 3 years; all CT scans of abdomen, pelvis, and urinary tract were reviewed. Clinical indications, radiological reports, patient demographics, diagnosis, and stone parameters were reviewed.
Results:
12,048 CT scans from 9,853 patients were reviewed. Median age was 56.4 years (range 16-96 years). >50% of the scans were undertaken for suspected renal colic. Only 41% of the patients suspected to have stones were confirmed on CT.
595 patients had incidental diagnosis of stone disease; more than 66.7% of these inpatients investigated for haematuria. In 2,651 patients with stone disease, 53% were renal stones and thrice more likely to be in the lower pole calyx. Half of the stone patients had multiple stones.
42% had ureteric stones. 66.7% of these patients had stone in the lower ureter and 25% in the upper ureter. Hydronephrosis was absent in 25% of the patients and mild renal pelvis dilatation reported in half of the group.
Conclusions:
NCCT remains the gold standard in diagnosing renal and ureteric stones. Positive predictive value for clinical diagnosis was 41%. 16% of stone patients had haematuria.
Half the stone patients had ureteric stones. Ultrasound would have failed to diagnose stones in 25% of patients and in half with only mild dilatation of the renal pelvis, suggesting the need for NCCT in patients <50 years with abdominal pain and haematuria.
Non-contrast Computed Tomography (NCCT) is the diagnostic benchmark for urinary stones. This study evaluates the diagnostic accuracy in detecting kidney/ureteric stones, including those patients presenting with haematuria.
Materials Methods:
Over 3 years; all CT scans of abdomen, pelvis, and urinary tract were reviewed. Clinical indications, radiological reports, patient demographics, diagnosis, and stone parameters were reviewed.
Results:
12,048 CT scans from 9,853 patients were reviewed. Median age was 56.4 years (range 16-96 years). >50% of the scans were undertaken for suspected renal colic. Only 41% of the patients suspected to have stones were confirmed on CT.
595 patients had incidental diagnosis of stone disease; more than 66.7% of these inpatients investigated for haematuria. In 2,651 patients with stone disease, 53% were renal stones and thrice more likely to be in the lower pole calyx. Half of the stone patients had multiple stones.
42% had ureteric stones. 66.7% of these patients had stone in the lower ureter and 25% in the upper ureter. Hydronephrosis was absent in 25% of the patients and mild renal pelvis dilatation reported in half of the group.
Conclusions:
NCCT remains the gold standard in diagnosing renal and ureteric stones. Positive predictive value for clinical diagnosis was 41%. 16% of stone patients had haematuria.
Half the stone patients had ureteric stones. Ultrasound would have failed to diagnose stones in 25% of patients and in half with only mild dilatation of the renal pelvis, suggesting the need for NCCT in patients <50 years with abdominal pain and haematuria.
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