Рентгенология & Радиология, 2010, XLІХ 190-195

Multimodal diagnostic imaging in patients withurolithiasis
V. Hadzhiyska1, T. Petrov1, I. Kostadinova1, V. Mladenov2,
V. Marianovski3, V. Stoinova4

1Clinic of Nuclear Medicine,
2Clinic of Urology, Medical University – Sofia,
3Clinic of Urology, Pirogov Emergеncy Hospital – Sofia,
4Computed Тomography, University Hospital “St. Ekaterina” – Sofia


The practice shows that till now there is no complex imaging method that provides full and correct informationabout urolithiasis, possible complications and the therapy effect. The aim of the study was to apply a new multimodal diagnostic method in patients with urolithiasis. We had to estimate its significance for the diagnosis of calculosis and the degree of persistent complications. Thirty patients (15 male, 15 female) with 60 kidneys, middle age – 46, 5 years, were studied. All of them first underwent ultrasonography (US). Then, the patients were examined with a new hybrid technology, including dynamic renal scintigraphy (DRS), single photon emission computed tomography (SPECT) and low dose computed tomography (CT). A diuretic test with furosemide was performed in 16 patients (53%). By using the combined method (DRS – SPECT/CT), urolithiasis and its complications was found in 24 (80%) patients. With the low dose CT were detected 43 concrements, 30 of them in the kidney and 13 in the ureter. After performing DRS, a different degree of impaired drainage was determined in 25 (42%) of the investigated kidneys. Secondary sings of obstruction on CT were found in 15 (25%) of the kidneys. The diuretic test showed: obstructive nephropathy in 15 of the kidneys (25%), non-obstructive nephropathy – in 11(18%), and intermediate reaction – in 8 (13%) of the kidneys. Our first experience in appliance of SPECT/CТ shows that this method provides complex functional and morphological information of urolithiasis and shortens the diagnostic process by performing single complex study.

Key words: