TY - JOUR
T1 - Unenhanced MDCT in suspected urolithiasis
T2 - Improved stone detection and density measurements using coronal maximum-intensity-projection images
AU - Corwin, Michael T
AU - Hsu, Margaret
AU - McGahan, John P
AU - Wilson, Machelle
AU - Lamba, Ramit
PY - 2013/11
Y1 - 2013/11
N2 - OBJECTIVE. The purpose of this study was to determine whether coronal maximum-intensity-projection (MIP) reformations improve urinary tract stone detection and density measurements compared with routine axial and coronal images. MATERIALS AND METHODS. Forty-five consecutive patients who underwent MDCT for suspected urolithiasis were included. Two radiologists independently determined the number of stones on 5-, 3-, and 1.25-mm axial, 5- and 3-mm coronal, and 5-mm coronal MIP images. The reference standard was obtained by consensus review using all six datasets. Stone density was determined for all calculi 4 mm or larger on all datasets. RESULTS. There were a total of 115 stones. Reader 1 identified 111 (96.5%), 112 (97.4%), 97 (84.3%), 102 (88.7%), 99 (86.1%), and 85 (73.9%) stones and reader 2 identified 105 (91.3%), 102 (88.7%), 85 (73.9%), 89 (77.4%), 89 (77.4%), and 76 (66.1%) stones on the MIP, 1.25-mm axial, 3-mm axial, 3-mm coronal, 5-mm coronal, and 5-mm axial images, respectively. Both readers identified more stones on the MIP images than on the 3- or 5-mm axial or coronal images (p < 0.0001). The mean difference in stone attenuation compared with the thin axial images was significantly less for the MIP images (44.6 HU) compared with 3-mm axial (235 HU), 3-mm coronal (309 HU), and 5-mm coronal (329.6 HU) or axial images (347.8 HU) (p < 0.0001). CONCLUSION. Coronal MIP reformations allow more accurate identification and density measurements of urinary tract stones compared with routine axial and coronal reformations.
AB - OBJECTIVE. The purpose of this study was to determine whether coronal maximum-intensity-projection (MIP) reformations improve urinary tract stone detection and density measurements compared with routine axial and coronal images. MATERIALS AND METHODS. Forty-five consecutive patients who underwent MDCT for suspected urolithiasis were included. Two radiologists independently determined the number of stones on 5-, 3-, and 1.25-mm axial, 5- and 3-mm coronal, and 5-mm coronal MIP images. The reference standard was obtained by consensus review using all six datasets. Stone density was determined for all calculi 4 mm or larger on all datasets. RESULTS. There were a total of 115 stones. Reader 1 identified 111 (96.5%), 112 (97.4%), 97 (84.3%), 102 (88.7%), 99 (86.1%), and 85 (73.9%) stones and reader 2 identified 105 (91.3%), 102 (88.7%), 85 (73.9%), 89 (77.4%), 89 (77.4%), and 76 (66.1%) stones on the MIP, 1.25-mm axial, 3-mm axial, 3-mm coronal, 5-mm coronal, and 5-mm axial images, respectively. Both readers identified more stones on the MIP images than on the 3- or 5-mm axial or coronal images (p < 0.0001). The mean difference in stone attenuation compared with the thin axial images was significantly less for the MIP images (44.6 HU) compared with 3-mm axial (235 HU), 3-mm coronal (309 HU), and 5-mm coronal (329.6 HU) or axial images (347.8 HU) (p < 0.0001). CONCLUSION. Coronal MIP reformations allow more accurate identification and density measurements of urinary tract stones compared with routine axial and coronal reformations.
KW - Maximum intensity projection
KW - MDCT
KW - Nephrolithiasis
KW - Renal stones
KW - Urolithiasis
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U2 - 10.2214/AJR.12.10389
DO - 10.2214/AJR.12.10389
M3 - Article
C2 - 24147474
AN - SCOPUS:84886477686
VL - 201
SP - 1036
EP - 1040
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
SN - 0361-803X
IS - 5
ER -