Purpose. To study hemodynamic changes in patients with urolithiasis using CT perfusion.

Materials and methods. From 2017 to 2020 at the Department of Radiology №2 of the University Clinical Hospital №1 and at the Institute of Urology and Human Reproductive Health of Sechenov University, 56 patients with urolithiasis were examined. All patients underwent preoperative MSCT with CT perfusion. The study was performed on a Toshiba Aquilion One 640 scanner in a volumetric mode with a slice thickness of 0.5 mm. The width of the high security field is 160 mm.

Results. In patients without dilatation of the pelvicalyceal system, mean values of cortical and cerebral blood flow (AF), blood volume (BV), and permeability (FE) were within normal limits. In the course of a comparative analysis of the results of the examination, the average indicators of blood flow velocity (AF), blood volume (BV) and permeability (FE) in the cortical and medulla in patients without PCS dilatation (Group 1) were within 10%. Changes in the contralateral kidney were not determined. Patients with PCS dilatation (Group 2) showed significant differences in blood flow parameters in the cortical and medulla of the kidney relative to the values obtained for the contralateral kidney. There was no decrease in perfusion values in the contralateral kidney.

In patients with ureterocalicopyeloectasia, there was a marked decrease in perfusion on the side of the obstruction. However, in the contralateral kidney, these indicators exceeded the normal values of perfusion, which is associated with the degree of functional impairment of the kidney with ureteral stone. The decrease in perfusion parameters in patients with ureterocalicopyeloectasia is more significant compared to that in patients with calicopyeloectasia, i.e. the degree of expansion of the PCS directly affects the change in blood flow.

Conclusion. CT perfusion performed on a 640-slice computed tomography scanner makes it possible to objectively assess changes in blood flow in the kidney in patients with ureteral calculus.