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Area of Science:

  • Urology
  • Radiology
  • Medical Imaging

Background:

  • Ureteral stones (kidney stones) can cause significant pain and complications.
  • Accurate stone size measurement is crucial for predicting spontaneous passage versus the need for surgical intervention.
  • Computerized tomography (CT) is a primary imaging modality for diagnosing ureteral stones.

Purpose of the Study:

  • To compare the maximum diameter of ureteral stones in the coronal plane versus the axial plane on CT scans.
  • To determine the clinical significance of the coronal stone diameter in predicting stone passage.

Main Methods:

  • Retrospective chart review of 150 patients with ureteral stones who underwent CT with coronal reconstructions.
  • Data collected included stone diameter (axial and coronal), stone location, patient age, and management outcome (spontaneous passage or surgery).
  • Multivariate regression analysis was used to identify factors predicting spontaneous stone passage.

Main Results:

  • The coronal diameter was larger than the axial diameter in 75% of cases.
  • On multivariate analysis, coronal diameter (P<.001), stone location (P=.01), and patient age (P=.03) were significant predictors of spontaneous passage.
  • Only coronal diameter remained a significant predictor of stone passage versus surgical intervention.

Conclusions:

  • The coronal diameter of ureteral stones on CT imaging is a key factor in predicting spontaneous passage.
  • Obtaining coronal reconstructions during CT for ureteral stones is recommended to guide clinical management and patient counseling.
  • Coronal diameter measurement aids in differentiating between conservative management and surgical intervention for ureteral stones.