Computed Tomography Findings in the Evaluation of Urolithiasis

Abstract

Background: Urolithiasis, or the formation of urinary tract stones, is a prevalent condition that affects individuals worldwide, predominantly impacting middle-aged and elderly demographics. Computed tomography (CT) has emerged as a superior diagnostic tool for urolithiasis due to its high sensitivity and specificity, offering detailed insights into the size, location, density, and composition of stones. Objective: The objective of this study was to evaluate the efficacy of unenhanced computed tomography in the diagnosis and characterization of urinary tract stones, focusing on their size, location, and associated clinical symptoms. Methods: A cross-sectional study was conducted at the Diagnostic Center of CMH Hospital Lahore over four months, involving 70 patients with suspected or confirmed urolithiasis. Participants were selected using non-probability convenient sampling and underwent 128-slice MDCT imaging without contrast. Data collection included demographic information, clinical symptoms, and CT findings regarding stone characteristics. The ethical standards adhered to the Declaration of Helsinki, with all participants providing informed consent. Results: The study comprised 74.3% male and 25.7% female participants, with the highest prevalence of urolithiasis observed in the 30-40 year age group (32.9%). CT imaging detected stones in 95.7% of the participants, with a significant incidence of smaller stones (1-5 mm) at 31.4%. Hydronephrosis was noted in 85.7% of cases, and hydroureter in 54.3%. The most common stone density ranged from 500-1000 HU (41.4%), and stones were more frequently located on the right side (32.9%). Conclusion: Unenhanced CT proved to be a highly effective diagnostic tool for assessing urinary tract stones, providing essential data on stone size, density, and location, as well as associated clinical symptoms. This modality enhances the ability to tailor treatment strategies effectively, thereby improving patient outcomes.