Imaging Modalities for Renal Calculus



AXR. KUB

 - Good far calcium-containing stones useful when limited radiation dose is desirable, e.g. in pregnancy

 - Frequent X-rays useful tor stone clearance/recurrence or growth assessment to reduce total radiation dose

Ultrasound

 - Safe, non-invasive

 - High sensitivity for obstruction

 - Better tor ureteropelvic junction and ureterovesical junction stones

Non-contrast CT

 - Rapid. highly accurate. highly sensitive and specific (97—100%) for ureteric and renal stones

 - Accurate delineation of size and location, obstruction

 - Able to identify non-calculus causes of flank or abdominal pain: diagnoses retroperitoneal disease

CT-KUB

 - Combination of above

MRI

 - Limited value: cannot identify calcifications

 - Costly and time-consuming for ureteric and renal stones

IVP

 - Combines calcific stone detection with function and anatomy (collecting system duplication, calyceal diverticulae). degree and level of obstruction

 - Useful for non-calculus causes of obstruction (papillary necrosis, polyps. urothelial tumors)

 - Limited IVP can be used in pregnancy (lower dose than a CT-based scan) when an ultrasound is inconclusive

Surgical—retrograde cystoscopy and ureteroscopy

 - Imaging associated with surgical access to the lower and upper urinary tract: diagnostic and therapeutic



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