Coronal Imaging to Assess Urinary Tract Stone Size

Nadler, Robert B.; Stern, Jeffrey A.; Kimm, Simon; Hoff, Frederick L.; Rademaker, Alfred

doi:10.1097/01.ju.0000134885.08558.88

Cited by 64 publications

(31 citation statements)

References 6 publications

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“…In these cases, when the contrast-enhanced phase does not allow an accurate diagnosis, it is recommended that the patient is recalled for a new evaluation by means of a unenhanced phase, therefore without any direct clinical impact, but just with a certain discomfort for the patient who must return to the unit of CT for undergoing a further CT scan (12) . In seven patients, renal calculi were identified, six of them non-obstructive, and the majority with < 6 mm in diameter and found in asymptomatic patients (24,25) . The absence of symptoms and the presence of small, non-obstructive calculi seem to represent favorable signs for indicating an expectative approach (26) .…”

Section: Discussionmentioning

confidence: 99%

O valor da fase sem contraste na tomografia computadorizada do abdome

et al. 2008

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OBJECTIVE: To determine the role of the unenhanced phase of abdominal computed tomography in patients without a definite diagnosis or undergoing tumor staging. MATERIALS AND METHODS: A prospective and transversal study was developed with 100 consecutive patients submitted to unenhanced and contrastenhanced abdominal computed tomography. Two observers evaluated all the computed tomography images in the contrast-enhanced phase (first analysis) and, later, in the unenhanced phase (second analysis) in an attempt to establish the primary and secondary diagnoses as a function of the clinical indication for the study. The frequency of changes in the diagnoses resulting from a combined analysis of the images in the pre-and post-contrast phases was evaluated. Cases with changes in the diagnosis were reviewed by clinical specialists for determining possible changes in the therapeutic approach. RESULTS: Primary and secondary diagnoses were changed in respectively 1 and 18 cases (p = 1.000; p = 0.143) as follows: steatosis, adrenal nodules, nephrolithiasis, renal cysts and hepatic calcification. In the cases where the unenhanced phase changed the diagnosis, the specialists changed the therapeutic approach in 14 of the 19 patients (73%) (p = 0.038). CONCLUSION: No significant change was observed in the primary or secondary diagnosis as a result of the findings in the unenhanced phase. However, changes in secondary diagnoses affected the therapeutic approach adopted by the specialists. Keywords: Computed tomography; Contrast media; Abdomen.OBJETIVO: Determinar o valor agregado da fase sem meio de contraste da tomografia computadorizada do abdome em pacientes sem diagnóstico determinado ou em estadiamento tumoral. MATERIAIS E MÉTODOS: Estudo prospectivo e transversal em 100 pacientes consecutivos submetidos a tomografia computadorizada abdominal sem e com meio de contraste intravenoso. Dois examinadores avaliaram todos os exames, procurando estabelecer, através da fase com meio de contraste intravenoso (primeira análise) e posteriormente através da fase sem contraste (segunda análise), o diagnóstico principal e os secundários em função da indicação clínica do exame. Mediu-se a freqüência de mudança diagnóstica decorrente da análise combinada das fases pré-e pós-contraste intravenoso. Casos que tiveram mudança diagnóstica foram avaliados por especialistas clínicos para determinar se implicaria mudanças de conduta. RESULTADOS: Diagnósticos principal e secundário foram modificados em 1 e 18 casos, respectivamente (p = 1,000; p = 0,143). Os diagnósticos modificados foram: esteatose, definição de nódulo em adrenal, nefrolitíase, classificação de cistos renais e calcificação hepática. Nos casos em que a fase sem contraste modificou o diagnóstico, os especialistas mudaram sua conduta em 14/19 (73%) dos pacientes (p = 0,038). CONCLUSÃO: A fase sem contraste não modificou significativamente o diagnóstico principal ou secundário. Porém, as mudanças nos diagnós-ticos secundários influenciaram na conduta adotada pelos especialistas. Unite...

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Section: Discussionmentioning

confidence: 99%

O valor da fase sem contraste na tomografia computadorizada do abdome

et al. 2008

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“…To date, researchers have reviewed demographic, radiological, and biochemical parametres and investigated the factors effecting spontaneous stone passage [5,[7][8][9][10]. In the detection of the presence and size of the stone, one of the imaging modalities such as KUB, US, IVP or CT can be used [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, although many imaging modalities are used, computed tomography (CT) has the highest diagnostic sensitivity [3,4]. In particular, multidedector CT (MDCT) provides coronal reconstruction which aids in the evaluation of all dimensions of stones [5]. So, we wanted to discover the factors that are effective on spontaneous stone passage by analysing the medical files of patients who had undergone MDCT.…”

Section: Introductionmentioning

confidence: 99%

Computed Tomographic Based Determination with all Aspect of Spontaneous Passage of Ureteral Stone

Buldu¹

2016

Eu Clin Anal Med

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Anahtar KelimelerÜreter Taşı; Kontrastsız Multidedektör Bilgisayarlı Tomografi; Spontan Pasaj Abstract Aim: The objective of this study is to determine tomographic measurement parametres that are effective on spontaneous passage (SP) of ureteral stones in patients who will undergo unenhanced multidetector computed tomographic examinations (MDCT). Material and Method: The patients who presented with complaints of renal colic to our clinic during 2013-2015 were retrospectively evaluated. The medical files of 813 patients were reviewed and the medical records of 331 cases who had undergone CT were examined. A total of 217 patients whose stone size was less than 10 mm were included in the study. The patients whose stones passed were included in Group 1, and those whose stones did not pass spontaneously were included in Group 2. Data about age and gender of the patients, location, laterality, history of spontaneous stone passage from the ipsilateral side, ureteroscopy, shock wave lithotripsy (SWL), anteroposterior (AP) diameter of the renal pelvis, diameter of the stone as measured on coronal and axial planes, stone volume, and average thickness of the renal parenchyma were evaluated. Parametres effecting passage of the stone were statistically analysed. Results: The mean age of the patients (female, n=152, and male, n=65) was 42.3 years. The patients had upper (n=73) and lower (n=144) ureteral stones. The median diameter of the renal pelvis (17.2 mm), stone diameter on the coronal plane (6.1 mm) and the axial plane (4.6 mm), and thickness of the renal parenchyma (20 mm) were measured. Statistical analysis revealed that the location, volume, diameter of the stone on the coronal and axial planes were influential factors on spontaneous stone passage. In logistic regression analysis, only the location of the stone and its diameter on the coronal plane were found to be independent effective factors on spontaneous stone passage. Discussion: In our study based on data retrieved from MDCT, the location and size of the stone were found to be independent factors affecting spontaneous stone passage. However, a surprising result is that the AP diameter of renal pelvis and renal parenchymal thickness, both of which are factors important for urologists, were not effective on SP.

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“…Although guidelines for treatment based upon stone size are well established [4,5,[8][9][10], there are only sparse reports in the literature regarding the preferred method for stone measurement using CT [11][12][13][14][15]. The most common method of measuring stone diameter in CT is estimation of maximal transverse dimension from axial images [13,16].…”

Section: Introductionmentioning

confidence: 99%