CT kidneys, ureters and bladder (protocol)
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Computed tomography of kidneys, ureters and bladder (CT KUB) is a quick non-invasive technique for diagnosis of urolithiasis. It is usually considered the initial imaging modality for suspected urolithiasis in an emergency setting 1.
NB: This article is intended to outline some general principles of protocol design. The specifics will vary depending on CT hardware and software, radiologists' and referrers' preference, institutional protocols, patient factors (e.g. allergy) and time constraints.
The purpose of CT KUB is primarily to assess for the presence of urolithiasis. Location of the stone, size, and secondary signs of renal tract obstruction can then be used to gauge the likelihood of passage and guide further management 3.
- supine with their arms above their head
- above the diaphragm to the below pubic symphysis
- above kidneys to below pubic symphysis
contrast injection considerations
- minimal scan delay
- respiration phase
- prone has the advantage of assessing stones near the vesicoureteric junction which may have just passed
- some institutions may perform a limited pelvic scan in prone if the supine scan shows a calculus near the vesicoureteric junction
- stone composition assessment can be done with dual energy CT
- identification of calcified renal tract calculi size and position
- assessment of the sequelae of calculi
- assessment of other causes of flank pain if negative for calculus disease
- presence of further calculi at risk of obstructing
- 1. Nadeem M, Ather MH, Jamshaid A et-al. Rationale use of unenhanced multi-detector CT (CT KUB) in evaluation of suspected renal colic. Int J Surg. 2012;10 (10): 634-7. doi:10.1016/j.ijsu.2012.10.007 - Pubmed citation
- 2. Chowdhury FU, Kotwal S, Raghunathan G et-al. Unenhanced multidetector CT (CT KUB) in the initial imaging of suspected acute renal colic: evaluating a new service. Clin Radiol. 2007;62 (10): 970-7. doi:10.1016/j.crad.2007.04.016 - Pubmed citation
- 3. Preminger G, Tiselius H, Assimos D et al. 2007 Guideline for the Management of Ureteral Calculi. J Urol. 2007;178(6):2418-34. doi:10.1016/j.juro.2007.09.107 - Pubmed