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Year :2019
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Month :
July-August
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Volume :
8
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Issue :
3
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Page :
RO26 - RO30
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JSS CT Scoring System for Management of Ureteric Calculi
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Correspondence Address :
Nagaraj Murthy, Ashwini Sindagi,
Dr. Ashwini Sindagi,
JSS Hospital, Mg Road, Mysuru-570004, Karnataka, India.
E-mail: ashjsssindagi@gmail.com
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Introduction: Introduction: Urolithiasis is a worldwide health issue which costs significant financial and man power burden. Dilemma exists among treating physicians in choosing appropriate line of management.
Aim: To evolve an objective scoring system based on CT parameters in management of ureteric calculus.
Materials and Methods: A total of 180 patients suffering from ureteric calculus and who underwent CT scan during January 2018 to February 2019 in Department of Radiology, JSS Medical College, Mysore, Karnataka, India, were included in this prospective study. Each parameter like size of calculus, site, peri-ureteric rim, ureteric dilatation just proximal to site of obstruction, renal parenchymal attenuation and peri-nephric fat stranding were scored on a point scale. A cut-off point of 13 of the total score was arrived based on statistics and was used in choosing the line of management. The predictions were correlated with actual successful line of management employed by the urologists in line with American Urological Association (AUA) guidelines.
Results: Out of 180 patients with ureteric calculus, most common site of ureteric calculus was upper ureter (43.3%) followed by Vesico Ureteric Junction (VUJ) (36.7%). Mean width of calculi which were treated by Medical Expulsive Therapy (MET) was 3.68 mm, whereas calculi with width of more than 6.0 mm were treated by interventional procedures. Nearly, 76% of patients with peri-nephric fat stranding and 92.6% with positive peri-ureteric rim sign underwent interventional procedures. Mean attenuation of the affected kidney was 30.93 Hounsfield Units (HU) and mean attenuation of unaffected kidney was 36 HU. Nearly, 90.48% of patients with scores equal or above 13 underwent interventional procedures and 83.33% of patients with scores below 13 were treated by MET.
Conclusion: The JSS CT scoring system is a unique point based system to objectively choose the suitable line of treatment in patients with ureteric calculus.
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