Detecting ureteral stones in cats with CT versus ultrasound

Abstract

BACKGROUND: Radiographs and ultrasound (US) are the primary imaging modalities used to assess ureteral calculi in cats. Reports describing the use of nonenhanced computed tomography (CT) are scarce. HYPOTHESIS/OBJECTIVES: To compare US and nonenhanced CT for detection, number and localization of ureteral calculi in cats. ANIMALS: Fifty-one cats with at least 1 ureteral calculus, and 101 ureters. METHODS: Prospective case series. All cats underwent an US followed by a nonenhanced CT. Cats were included in the study if at least 1 ureteral calculus was diagnosed on either modality. Number of calculi and their localization (proximal, middle, and distal) were recorded on both modalities. Pelvic dilatation and maximal ureteral diameter were recorded with US. RESULTS: More calculi were detected by nonenhanced CT (126) compared to US (90), regardless of localization (P&#xa0;<&#x2009;.001). More ureters were affected on nonenhanced CT (70) compared to US (57; P&#xa0;<&#x2009;.001). The number of calculi detected was significantly different between US and nonenhanced CT in the proximal (P&#xa0;=&#x2009;.02) and distal ureteral region (P&#xa0;<&#x2009;.001). Bilateral calculi were more frequent with nonenhanced CT (19 cats) compared to US (9 cats; P&#xa0;<&#x2009;.001). A pelvic size superior to 5&#x2009;mm and a maximal ureteral diameter value superior to 3&#x2009;mm were always associated with ureteral calculi. CONCLUSIONS AND CLINICAL IMPORTANCE: Computed tomography is an emerging imaging modality in cats with a suspected ureteral obstruction. Combination of CT and US can be beneficial for case management.