DISCUSSION
The data from this study showed that our
nonenhanced helical CT protocol is superior
to IVU in the detection of ureteric
stones. This finding is in accord with that
TABLE 2
Evaluation of Radiation Risk from Conventional IVU and Nonenhanced Helical CT
Examination
Total Energy
Imparted (mJ)*
Effective Dose
Equivalent (mSv)†
Conventional IVU‡
Anteroposterior 22.8 0.271
Posteroanterior 22.8 0.242
Total§ . . . 1.33
Helical CT 245# 2.76
251** 2.82
* Source.—Reference 8. Calculated by using 0.07 mJ/R · cm2 (0.271 mJ/cm2 per mC/kg).
† Source.—Reference 4. Calculated by using 11.9 μSv/mJ and 10.6 μSv/mJ for the anteroposterior
and posteroanterior IVU views, respectively, and by using a mean value of 11.25 μSv/mJ for
helical CT.
‡ For both the anteroposterior and posteroanterior views, the calculated skin exposure, in air
without backscatter, was 0.346 R (0.089 mC/kg), and the exposure-area product was 325 R · cm2
(83.8 cm2 · mC/kg).
§ Total values for one posteroanterior and four anteroposterior views.
For helical CT, the mean entrance dose, 1.5 R (0.387 mC/kg), was measured by using film
dosimetry and included backscatter. Values differed by less than 10% for three patients. The
nominal beam width was 7 mm, and the nominal pitch was 2:1, with 25 helical turns during the
examination.
# Calculation based on a uniform absorbed dose distribution throughout the volume, defined by
the surface area exposed to the x-ray beam and the cross-sectional area of 700 cm2 (20 3 35 cm).
** Calculation based on the exposure-area product and 0.1 mJ/R · cm2 (0.388 mJ/cm2 per
mC/kg) (reference 8), assuming a backscatter factor of 1.15.
TABLE 3
Relative Radiation Risk from Various
Nonenhanced Helical CT Protocols
for Diagnosis of Renal Colic
Reference
Study
Nominal
Beam
Width
(mm) Pitch
Relative
Radiation
Risk
Current study 7 2.0:1.0 1.0
Sommer et al (2) 5 1.6:1.0 1.3
Smith et al (1) 5 1.0:1.0 2.0
Volume 215