Ureteral Stone Diameter on Computerized Tomography Coronal Reconstructions is Clinically Important and Underreported: Tracy Marien
With ureteral stones a common problem in the United States, information regarding spontaneous passage of these stones is of relative importance. To date, stone size and location have been identified as important factors; however, this information is based largely off of axial stone diameter. The value of coronal reconstruction is not clearly defined in the literature, and may prove to be a valuable tool in determining maximal stone diameter.
To compare coronal and axial images, Dr. Marien and colleagues performed a retrospective analysis of patients with history of ureteral stones treated at their center. A total of 100 patients were included in their study, of which 45 spontaneously passed their ureteral stones, while the other 55 required intervention.
Their results revealed axial diameter, coronal diameter, age, stone location, and medical expulsion therapy (MET) were all associated with spontaneous stone passage. Within their cohort, only 18% had data regarding the coronal diameter of the stone. Amongst the patients who received both coronal and axial imaging, coronal diameter was greater in 70% of the cases by an average of 1.6 mm. Upon multivariate analysis, both axial and coronal diameter were associated with stone passage, along with stone location.
From this review, the authors concluded that acquiring both axial and coronal measurements of ureteral stones is imperative to accurately assess stone size and determine the proper course for management.
Presented by Tracy Marien at the 2015 World Congress of Endourology Annual Meeting – October 1-4, 2015, London, United Kingdom.
Written by Austin Drysch for UroToday.com