Unenhanced multidetector CT evaluation of urinary stones and secondary signs in pediatric patients

This retrospective study evaluated the unenhanced multi-detector computed tomography (MDCT) findings of urinary system calculi and the secondary signs associated with ureteral stones in children. The study included 87 children (54 boys, 32 girls) with a mean age of 89 months (range: 5 months to 16 years) who were referred to us from various departments and were evaluated with unenhanced MDCT between January 2004 and June 2005. The patients were retrospectively evaluated by 2 radiology specialists by means of PACS (picture archiving and communication systems) with regard to the presence of stones, and localization and secondary signs associated with ureteral stones, such as hydronephrosis, proximal ureteral dilatation, unilateral renal enlargement, perinephric edema, tissue rim sign, decreased renal density, and periureteral edema. Patients were scanned by 4- and 16-slice MDCT. Urinary system calculi were detected in 47 (54%) children. An isolated stone in the urinary bladder was detected in one patient. In the remaining 46 children, 43 of the detected stones were renal stones and 23 of them were ureteral stones. Secondary signs associated with ureteral stones were detected in 69.6% of children who had ureteral stones. MDCT provided evaluation of the secondary signs associated with ureteral stones as well as the direct visualization of the stones in cases with urinary stone disease. The ability of MDCT to detect the secondary signs associated with ureteral stones supported the diagnoses and may aid in diagnosis when difficulties are present.