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What Does My CT Scan Test Report Indicate?

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Posted on Tue, 11 Oct 2016
Question: Hi,
Last Friday I came down with pain in lower abdomen and lower back. CT Scan revealed a 4mm Stone in the left ureter very close to the bladder. CT Scan report said -
" 4 mm obstructing stone along the distal left ureter at the level of the left      
ureterovesicular junction with mild left-sided hydroureter and left-sided      
hydronephrosis. No right-sided nephrolithiasis. No right-sided hydronephrosis.      
Otherwise, the kidneys appear to be unremarkable bilaterally.      

Visualized bowel appears to be unremarkable. No evidence for diverticulitis.      
Appendix appears normal. No evidence for bowel obstruction. No significant free      
fluid or free air. Bladder is nondistended. No significant retroperitoneal or      
pelvic lymphadenopathy.

After Friday, I am completely without any symptoms - no pain, no fever. Went to see the urologist yesterday. He asked to do an ultrasound to see if the stone had passed. In the ultrasound the report said -
"Both kidneys are normal in size, contour and echotexture. Right kidney measures 9.7 cm in length, and left kidney measures
9.9 cm in length. There is a 5 mm echogenic focus in the midpole of the right kidney. There is a 4 mm echogenic focus in
the midpole of the left kidney. There is an additional 7 mm echogenic focus in the upper pole of the left kidney. Findings are
consistent with bilateral nephrolithiasis. There is no hydronephrosis. There are subcentimeter cortical cysts within both
kidneys. In the right kidney, there is a 9 mm cortical cyst in the lower pole. In the left kidney, there is a 7 mm cortical cyst in
the lower pole. There is no perinephric fluid collection."

So, I am confused - (1) The CT scan is supposed to be more acurate, so can the ultrasound report be a false positive or a reading error? (2) The CT scan says there was only one stone, so how can 3 more stones apepar in the ultrasound in just 5 days?
Appreciate the help
doctor
Answered by Dr. Dr. P. T. Patil (28 hours later)
Brief Answer:
C.T Scan is very sensitive and precise test .

Detailed Answer:
Hello
Thanks for query and highlighting C.T Scan and subsequent Ultrasound Scanning report.

C.T scan is very precise and sensitive test and detects stone of smallest size.Whereas Ultrasound Scanning there are chances of human error .

Since you do not have pain and stone at UV Junction on left side being very small it is likely that it has passed out .

You can take C.T report with you and consult Sonologist to rectify his errors He will repeat USG and look carefully for stones that he has reported .

Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (15 hours later)
Thank you Doctor!

I will talk to my urologist tomorrow. Based on the slightly confusing data and your reply, it appears that the Ultrasound was either not read right or then it is a false positive given that the CT scan taken 5 days before does not see any additional kidney stone.

Question - Does it make sense to get another CT scan done just to get a confirmation? and, would it be better to do a non-contrast MRI versus a CT scan since it involves less radiation? Is the MRI just as accurate as the CT Scan?

Thanks much!
XXXX
doctor
Answered by Dr. Dr. P. T. Patil (3 hours later)
Brief Answer:
I would suggest to wait for a month and if need arises get CT scan done

Detailed Answer:
Hello
Thanks for follow up .

Since your problem is not serious If you were my patient I would have suggested you to wait for 4 weeks and repeat Ultrasound Scanning with other Sonologist and depending on his findings decide need for C.T Scan or MRI.

Both C.T \Scan and M.R.I are equally very sensitive tests and both have their efficacy in diagnosis urinary diseases . C.T scan is preferred in stone diseases whereas M.R.I is advised in soft tissue tumors of the urinary organs .In M.R.I magnetic energy is used to detect the anatomical diffect instead of radiation as in C.T Scan However radiation exposure in C.T scan is well within limits of acceptable range and not harmful to the body .

Thanks and Regards..
Dr.Patil.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10583 Questions

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What Does My CT Scan Test Report Indicate?

Brief Answer: C.T Scan is very sensitive and precise test . Detailed Answer: Hello Thanks for query and highlighting C.T Scan and subsequent Ultrasound Scanning report. C.T scan is very precise and sensitive test and detects stone of smallest size.Whereas Ultrasound Scanning there are chances of human error . Since you do not have pain and stone at UV Junction on left side being very small it is likely that it has passed out . You can take C.T report with you and consult Sonologist to rectify his errors He will repeat USG and look carefully for stones that he has reported . Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you . Thanks and Regards. Dr.Patil.