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Abdominal Radiography After CT Reveals Urinary Calculi

A Method to Predict Usefulness of Abdominal Radiography on the Basis of Size and CT Attenuation of Calculi

¹ All authors: Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157-1088.

View larger version (138K): [in a new window]   Fig. 1A. —19-year-old woman with suprapublic pain. Unenhanced CT scan shows 3-mm calculus (attenuation, 491 H; arrow) at right ureterovesicle junction.

View larger version (137K): [in a new window]   Fig. 1B. —19-year-old woman with suprapubic pain. Coned-down view of pelvis from digital abdominal radiograph shows radiopaque calculus (arrow) seen in A.

View larger version (165K): [in a new window]   Fig. 2A. —47-year-old man with right flank pain. Unenhanced CT scan shows 1-mm calculus (attenuation, 209 H; arrow) in right kidney.

View larger version (146K): [in a new window]   Fig. 2B. —47-year-old man with right flank pain. Coned-down view of right kidney from digital abdominal radiograph shows normal findings. CT-revealed kidney calculus is not visible.

View larger version (8K): [in a new window]   Fig. 3. —Scattergram shows calculus size and density versus visibility on abdominal radiograph. Calculi that were detected on abdominal radiographs are indicated by [UNK]. Calculi that were not detected on abdominal radiographs are indicated by [UNK].

View larger version (163K): [in a new window]   Fig. 4A. —45-year-old man with lower abdominal and suprapubic pain. Unenhanced CT scan of upper pole of left kidney shows 2-mm calculus (attenuation, 137 H; arrow). Second 4-mm calculus (305 H, not shown) in lower pole of kidney was also detected.

View larger version (138K): [in a new window]   Fig. 4B. —45-year-old man with lower abdominal and suprapubic pain. Coned-down view of left kidney from digital abdominal radiograph reveals vague density (arrow) initially believed to be upper pole calculus. It is probably superimposed density rather than calculus. Lower pole calculus (arrowhead) is visible on radiograph.

View larger version (156K): [in a new window]   Fig. 5A. —56-year-old man with right flank pain. Unenhanced CT scan shows 3-mm right ureteral calculus (attenuation, 501 H; arrow).

View larger version (163K): [in a new window]   Fig. 5B. —56-year-old man with right flank pain. Digital radiograph shows no visible calculus, but site of calculus is largely obscured by sacrum and stool-containing colon.

View larger version (21K): [in a new window]   Fig. 6. —Algorithm for predicting usefulness of abdominal radiography in evaluating urinary calculi in correlation to calculus attenuation.

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