CT Grading in Upper Urinary Tract Calculi with Kidney Infection

Background: This study is to establish a CT imaging grading system and to explore its value in evaluating upper urinary tract calculi with kidney infection. Methods CT images of 126 patients with kidney infection caused by upper urinary tract calculi were retrospectively analyzed. CT grading system was developed based on CT images. General information, clinical symptoms and examination data of patients in different CT grades were analyzed. With the occurrence of systemic inflammatory response syndrome (SIRS) as the end point, univariate and multivariate analysis was conducted to analyze the risk factors of SIRS. Results CT images were classified into 4 grades. For patients with different CT grades, the factors of fever, diabetes, blood white blood cell counts, urine leucocytes, CT1 (ratios of renal cortex CT values on the affected side and those on the healthy side), CT2 (ratios of renal pelvis CT values on the affected side and those on the healthy side), maximum body temperature, disease time, proportion of blood neutrophils, C-reactive protein, procalcitonin, and the size of stones had statistical significance (P<0.05). Only CT grading was statistically significant by multivariate analysis. The higher the CT grading, the greater the risk of SIRS, with 4.472 times higher of SIRS risk for each increasement of the CT grade. Conclusions CT images may reflect the involvement extent and scope of upper urinary tract calculi with kidney infection. The higher the CT grade is, the more severe the clinical symptoms are and the greater the risk of SIRS is.