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Achieving Ideal Computed Tomographic Scan Length in Patient With Suspected Urolithiasis

de Leon, Alberto Diaz MD; Xi, Yin MS; Champine, Julie MD; Costa, Daniel N. MD

Journal of Computer Assisted Tomography: March/April 2014 - Volume 38 - Issue 2 - p 264–267
doi: 10.1097/RCT.0000000000000016
Abdominal Imaging

Purpose The purposes of the study were to determine the frequency and magnitude of extension of computed tomographic (CT) scans performed for the evaluation of urolithiasis, to investigate the potential contributing factors for overscanning, and to establish potential landmarks to assist in estimating the location of the superior margin of the kidneys.

Materials and Methods This is a retrospective review of 300 CT studies performed for evaluation of urolithiasis. The total length of the scanned area, performing technologist, and the patient demographics were collected.

Results We found that scanning beyond the defined z-axis boundaries is a common phenomenon in CT examinations in patients with suspected urolithiasis with a magnitude that correlates (P < 0.0001) with patient time and setting: greater in the emergent (78.3 mm) and inpatient (79.8 mm) settings as well as on-call hours (80.4 mm). Our study also shows the superior margin of T11 to be consistently within 3 mm of the superior margin of the kidney but not below it.

Conclusions Overextension along the z axis is a ubiquitous phenomenon. The appropriate prescription of scan length, however, is an easy, efficient, costless, and universally applicable strategy. In patients with suspected urolithiasis, the superior margin of T11 represents a potential landmark to assist in estimating the upper margin of the kidneys.

From the Department of Radiology, Division of Abdominal Imaging, University of Texas Southwestern Medical Center, Dallas, TX.

Received for publication June 28, 2013; accepted September 20, 2013.

Reprints: Alberto Diaz de Leon, MD, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390–8896 (e-mail:

The authors declare no conflict of interest.

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