Current Status on New Technique and Protocol in Urinary Stone Disease

Abstract

Purpose of the Review This review article aims to show the actual role of Imaging, especially DECT (Dual Energy CT), in recognition of renal calculi. Recent Findings CT and in particular DECT have some implications in renal stone disease; CT is considered the gold-standard in the diagnosis in case of acute flank pain caused by nephrolithiasis, better than ultrasound, that represent the first approach, in some specific cases. DECT instead in these days, has increase a very particular role. Summary About 12% of the world’s population will experience urinary stones, and 50% of affected people experience a recurrence within 10 years after their first diagnosis. There are many different types of calculi, that could form and stay or could form and then goes to localize in different anatomical site in the urinary system: kidney, ureters, bladder, and urethra. Calculi, especially with high dimensions, cause the typical flank pain, also known as renal colic. The precise cause of their formation is still unknown, it is frequently believed that mineral deposition on a nidus of the mucoprotein matrix is what causes them to form. The preferred Imaging method for detecting urinary stones is ultrasonography (used like the first approach), and Computed Tomography (gold standard), more rapid if “low-dose CT”. In these days, Dual Energy Computed Tomography is useful to determine the composition of the calculation. In fact, it is more effective than single-energy CT; it creates a better separation of stones from iodine; and it allows better measures of stone composition with better differentiation of urate stones from others (even at low doses).

Obstruction from endometriosis causing hydronephrosis and complex renal pelvis rupture: A case report

“…Ultrasonography imaging was considered; however, kidney stones are best diagnosed on CT with or without contrast. Ultrasonography can be used effectively to screen for obstruction, particularly for those with a benign presentation and recurrent history, which can decrease CT in the ED up to 50% [ 4 ]. This patient did not have kidney stones on imaging; however, she did mild hydronephrosis of the left kidney, indicating stricture and/or obstruction.…”

Imaging of Kidney Stones: CT Urography, Ultrasound, and Stone Composition Analysis

“…Unique features like the "rim sign" aid in differentiating urinary calculi from other pathologies. Overall, noncontrast CT scans are an essential and effective tool in the investigation and management of urinary tract stones (3).…”

“…However, the predominant theory is that they result from the accumulation of minerals on a mucoprotein matrix, which acts as a nidus, or focal point, for stone development. This process of mineral deposition is complex and influenced by various physiological factors (3).…”