Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT
Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT
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DOI：
10.2214/ajr.178.1.1780101
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发表时间：
2002-01-01
影响因子：
5
通讯作者：
Smith, RC
中科院分区：
文献类型：
--
作者：
Coll, DM;Varanelli, MJ;Smith, RC
OBJECTIVE.先前的研究使用X线摄影检查输尿管结石的大小和位置与自发通过概率的关系。鉴于非增强CT在诊断急性输尿管结石中的准确性和新作用，我们研究了非增强CT确定的结石大小和位置与自发通过率的关系。在29个月的时间里，850例急性腰痛患者接受了非增强CT检查。回顾性分析了172例输尿管结石患者的CT诊断：115例结石自行排出，57例需要干预。结石尺寸定义为轴向CT切片平面内的最大直径。结石位置分为输尿管近端（骶髂关节上方）、输尿管中段（骶髂关节上方）、输尿管远端（骶髂关节下方）和输尿管膀胱交界处。直径1 mm结石的自发通过率为87%; 2-4 mm结石的自发通过率为76%; 5-7 mm结石的自发通过率为60%; 7-9 mm结石的自发通过率为48%;大于9 mm结石的自发通过率为25%。输尿管近端结石、中段结石、远端结石和输尿管膀胱连接部结石的自然通过率分别为48%、60%、75%和79%。输尿管结石的自发通过率确实随结石的大小和CT所确定的位置而变化。这些发生率与先前基于放射摄影发表的发生率相似。
OBJECTIVE. Prior studies using radiography have examined the relationship of ureteral stone size and location to the probability of spontaneous passage. Given the improved accuracy and new role of unenhanced CT in the diagnosis of acute ureterolithiasis, we studied the relationship of stone size and location as determined by unenhanced CT to the rate of spontaneous passage.MATERIALS AND METHODS. Over a 29-month period, 850 patients with acute flank pain were evaluated with unenhanced CT. Confirmation of the CT diagnosis was obtained retrospectively for 172 patients with ureteral stones: 115 stones passed spontaneously and 57 required intervention. Stone size was defined as the maximum diameter within the plane of the axial CT section. Stone location was classified as proximal ureter (above the sacroiliac joints), mid ureter (overlying the sacroiliac joints), distal ureter (below the sacroiliac joints), and ureterovesical junction.RESULTS. The spontaneous passage rate for stones 1 mm diameter was 87%; for stones 2-4 nun, 76%; for stones 5-7 mm, 60%; for stones 7-9 mm 48%; and for stones larger than 9 mm, 25%. Spontaneous passage rate as a function of stone location was 48% for stones in the proximal ureter, 60% for mid ureteral stones, 75% for distal stones, and 79% for ureterovesical junction stones.CONCLUSION. The rate of spontaneous passage of ureteral stones does vary with stone size and location as determined by CT. These rates are similar to those previously published based on radiography.