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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
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DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Imaging for Urinary Stones: Update in 2015.

Luca Villa1, Guido Giusti2, Thomas Knoll3

  • 1Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.

European Urology Focus
|July 21, 2017
PubMed
Summary

Noncontrast-enhanced computed tomography (CT) is the most accurate imaging technique for diagnosing urinary stones. Abdominal ultrasound is a viable alternative for initial evaluation, with new low-dose CT protocols minimizing radiation exposure.

Keywords:
Computr tomographyImagingIntravenous pyelogramNephrolithiasisRadiation exposureUltrasonographyUrolithiasis

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Area of Science:

  • Radiology
  • Urology
  • Medical Imaging

Background:

  • Imaging is crucial for diagnosing and managing patients with urinary stones.
  • The choice of imaging technique impacts clinical decision-making.

Purpose of the Study:

  • To evaluate the benefits and limitations of various imaging modalities for urinary stones.
  • To focus on the application of imaging techniques across different stages of patient management.

Main Methods:

  • A systematic literature search was conducted in PubMed and Web of Science.
  • Studies published in the last 10 years on urolithiasis, nephrolithiasis, or urinary stones and imaging were included.
  • Search terms combined stone-related terms with imaging modalities and radiation exposure.

Main Results:

  • Noncontrast-enhanced computed tomography (CT) offers the highest diagnostic accuracy for urinary stones.
  • Dual-energy CT can assess stone composition, while contrast-enhanced CT is useful for anatomical details and alternative pathologies.
  • Low-dose CT protocols, dual-split bolus, and adaptive statistical image reconstruction reduce radiation exposure.
  • Abdomen ultrasound is a valid initial approach, particularly for children and pregnant women, without altering patient outcomes compared to CT.

Conclusions:

  • Noncontrast-enhanced CT is the premier imaging technique for identifying urinary stones.
  • Abdomen ultrasound serves as a practical alternative for the initial assessment of urinary colic.
  • Advancements in low-dose protocols and imaging strategies aim to mitigate radiation risks, a significant concern in specific patient groups.