Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Building 10, Room 1C224D, 10 Center Drive, Bethesda, MD, 20892-1182, USA.
Department of Radiology, School of Medicine & Public Health, The University of Wisconsin, Madison, WI, USA.
Abdom Radiol (NY). 2024 Jan;49(1):173-181. doi: 10.1007/s00261-023-04075-w. Epub 2023 Oct 31.
Measuring small kidney stones on CT is a time-consuming task often neglected. Volumetric assessment provides a better measure of size than linear dimensions. Our objective is to analyze the growth rate and prognosis of incidental kidney stones in asymptomatic patients on CT.
This retrospective study included 4266 scans from 2030 asymptomatic patients who underwent two or more nonenhanced CT scans for colorectal screening between 2004 and 2016. The DL software identified and measured the volume, location, and attenuation of 883 stones. The corresponding scans were manually evaluated, and patients without follow-up were excluded. At each follow-up, the stones were categorized as new, growing, persistent, or resolved. Stone size (volume and diameter), attenuation, and location were correlated with the outcome and growth rates of the stones.
The stone cohort comprised 407 scans from 189 (M: 124, F: 65, median age: 55.4 years) patients. The median number of stones per scan was 1 (IQR: [1, 2]). The median stone volume was 17.1 mm (IQR: [7.4, 43.6]) and the median peak attenuation was 308 HU (IQR: [204, 532]. The 189 initial scans contained 291stones; 91 (31.3%) resolved, 142 (48.8%) grew, and 58 (19.9) remained persistent at the first follow-up. At the second follow-up (for 27 patients with 2 follow-ups), 14/44 (31.8%) stones had resolved, 19/44 (43.2%) grew and 11/44 (25%) were persistent. The median growth rate of growing stones was 3.3 mm/year, IQR: [1.4,7.4]. Size and attenuation had a moderate correlation (Spearman rho 0.53, P < .001 for volume, and 0.50 P < .001 for peak attenuation) with the growth rate. Growing and persistent stones had significantly greater maximum axial diameter (2.7 vs 2.3 mm, P =.047) and peak attenuation (300 vs 258 HU, P =.031) CONCLUSION: We report a 12.7% prevalence of incidental kidney stones in asymptomatic adults, of which about half grew during follow-up with a median growth rate of about 3.3 mm/year.
在 CT 上测量小肾结石是一项耗时的任务，常被忽略。体积评估比线性尺寸提供更好的尺寸测量。我们的目的是分析 CT 检查中无症状患者偶然肾结石的生长速度和预后。
本回顾性研究纳入了 2030 名无症状患者的 4266 次扫描，这些患者在 2004 年至 2016 年间接受了两次或更多次用于结直肠筛查的非增强 CT 扫描。DL 软件识别并测量了 883 颗结石的体积、位置和衰减。手动评估相应的扫描，并排除没有随访的患者。在每次随访时，将结石分为新发、生长、持续或消退。结石大小（体积和直径）、衰减和位置与结石的结局和生长速度相关。
结石队列包括 407 次扫描，来自 189 名患者（男：124 名，女：65 名，中位年龄：55.4 岁）。每次扫描的平均结石数为 1 个（IQR：[1，2]）。中位结石体积为 17.1mm（IQR：[7.4，43.6]），峰值衰减中位数为 308HU（IQR：[204，532]）。189 次初始扫描中包含 291 个结石；91 个（31.3%）消退，142 个（48.8%）生长，58 个（19.9%）在第一次随访时持续存在。在第二次随访（对于 27 名有 2 次随访的患者）时，44 个结石中有 14 个（31.8%）消退，19 个（43.2%）生长，11 个（25%）持续存在。生长结石的中位生长速度为 3.3mm/年，IQR：[1.4，7.4]。大小和衰减与生长速度具有中等相关性（Spearman rho 0.53，P <.001 为体积，0.50 P <.001 为峰值衰减）。生长和持续存在的结石的最大轴向直径（2.7 与 2.3mm，P =.047）和峰值衰减（300 与 258HU，P =.031）明显更大。
我们报告了在无症状成年人中偶然肾结石的患病率为 12.7%，其中约一半在随访期间生长，中位生长速度约为 3.3mm/年。
