Diagnostic value of renal parenchymal density difference on unenhanced helical computed tomography scan in acutely obstructing ureteral stone disease

Özer, Caner; Yencilek, Esin; Apaydın, Feramuz Demir; Duce, Meltem Nass; Yıldız, Altan; Erdem, Erim; Kanık, Arzu; Çayan, Selahíttín

doi:10.1016/j.urology.2004.03.058

Cited by 15 publications

(10 citation statements)

References 12 publications

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“…The basic mechanism of one of the parameters, DRPA, is the reduction in the density of renal parenchyma due to development of edema, increased renal lymphatic flow, fluid collection in the renal interstitial area and development of hyperemia after obstruction on the symptomatic side. 13 However, there was no statistically significant difference identified between DRPA and spontaneous passage. The greater occurrence of this symptom in a chronic period may be the reason for this result.…”

Section: Discussionmentioning

confidence: 86%

Noncontrast Ct Findings for Spontaneous Passage of Ureteral Stones

Sancak¹,

Sınık²,

Turan³

2016

ARC Journal of Urology

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Objective: The majority of ureteral stones with diameter smaller than 4 mm pass, while the majority of stones larger than 10 mm require intervention. The aim of this study is to evaluate patients with stones identified as 4-10 mm in size and determine the similarities and differences between patients who passed stones spontaneously (PPSS) and patients who required intervention (PRI). Methods: The study included 34 patients with complaint of acute flank pain and ureteral stones identified as 4-10 mm in size. The clinical data and non-contrast computed tomography (NCCT) images of patients were evaluated. Results: The mean age of patients was 42.5 ± 14.5 (20-62) years. While 13 patients spontaneously passed stones, 21 patients required intervention. The mean length of stones in the PPSS group was 5.86 ± 1.46 mm, while this was 7.38 ± 1.76 mm in the PRI group (p=0.025). The mean volume of PPSS stones was calculated as 181.67 ± 148.41 mm³, while the mean volume of PRI stones was 424.22 ± 273.22 mm³ (p=0.004). Findings identified to be in favor of spontaneous passage included small volume of ureteral stones and distal location, presence of perinephric fat stranding (PFS), hydronephrosis and lack of tissue-rim sign (TRS). The presence of PFS and absence of TRS had specificity of 100% and positive predictive value of 100% to determine spontaneous passage. Conclusions: In patients applying with renal colic linked to ureteral stones, evaluating ureteral stones and secondary signs with NCCT may determine which patients do not require intervention.

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Section: Discussionmentioning

confidence: 86%

Noncontrast Ct Findings for Spontaneous Passage of Ureteral Stones

Sancak¹,

Sınık²,

Turan³

2016

ARC Journal of Urology

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“…UHCT provides information regarding urinary stones, including their location, sizes, number, and attenuation values, with high sensitivity (95-98%) and specificity (96-100%), as shown by previous studies [2,3]. Recently, with the development of image processing and analysis of UHCT, several studies have reported the analysis of secondary signs on UHCT for urinary stones as result of physiologic changes in the obstructed kidney [4][5][6]. In addition, various studies have suggested the clinical influence of secondary signs or the correlation between stone factors and secondary signs on UHCT for urinary stone [7][8][9][10].…”

Section: Introductionmentioning

confidence: 85%

Secondary signs on preoperative CT as predictive factors for febrile urinary tract infection after ureteroscopic lithotripsy

Kim

Lee

et al. 2020

Preprint

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Background: Febrile urinary tract infection (UTI) is one of the most common complications after ureteroscopic lithotripsy (URS). We evaluated the effect of secondary signs on preoperative computed tomography (CT) for febrile UTI after URS. Materials and methods: In total, 182 patients who underwent URS for ureteral stones from January 2013 to December 2015 were included in this study. These patients were divided into two groups according to the presence of postoperative febrile UTI after URS. We retrospectively compared the clinical factors, stone factors, and secondary signs between the groups. Predictive factors for febrile UTI after URS were analyzed using a multivariate logistic regression model. Results: Febrile UTI occurred in 26 of the 182 patients. In univariate analysis, presence of comorbid chronic kidney disease (CKD) and stone size were significantly different between UTI and non-UTI groups. Among secondary signs, presence of hydroureter, perinephric fat stranding, periureteral fat stranding, and tissue rim sign were significantly different between the groups. In multivariate logistic regression analysis, comorbid CKD, stone size, perinephric fat stranding, and tissue rim sign were independent predictive factors for febrile UTI after URS. Conclusion: This study demonstrated that secondary signs including perinephric fat stranding and tissue rim sign on preoperative CT, CKD, and stone size are independent predictive factors for febrile UTI after URS.

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“…There are no previous studies in literature about this topic. Parenchymal density changes of the kidney was clinically shown in retrospective studies and compared with the cases in which obstruction was detected however no information was given about the duration of the obstruction (Georgiades et al, 2001;Goldman et al, 2004;Ozer et al, 2004). This study was considered to be beneficial for assesment of surgical treatment or conservative follow up options in cases with renal colic.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of hydronephrotic kidney parenchymal density by non-contrast multislice computed tomography

Yildirim¹,

Açıkgöz²,

Danacı³

et al. 2012

jecm

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ÖZETUzun süren üreteral obstrüksiyonun böbrek fonksiyon kaybına neden olduğu iyi bilinmektedir. Üriner sistem taşına bağlı herhangi bir obstrüksiyonun kontrastsız çok kesitli bilgisayarlı tomografi (KÇKBT) ile belirlenmesi tedavi zamanlaması hakkında karar vermek açısından çok önemlidir. Çalişmamızda deneysel hidronefroz oluşturulan ratlarda renal parankim dansitesinde meydana gelen değişiklikler KÇKBT ile değerlendirildi. Bu çalışmada sol üreterlerinde total veya parsiyel obstrüksiyon oluşturulmuş SpraqueDawley ratların böbrek parankim dansiteleri deneyin 1.,3. ve 30. günlerinde KÇKBT ile değerlendirilerek, sham ve kontrol grubu ratların böbrek parankim dansiteleri ile karşılaştırıldı. Parsiyel üreteral obstrüksiyon oluşturulmuş ratların böbrek parankim dansiteleri ile kontrol grubunun böbrek parankim dansiteleri arasında anlamlı bir fark olmadığı saptandı. Bununla birlikte total üreteral obstrüksiyon oluşturulmuş ratların böbrek parankim dansitelerinin karşı taraf böbrekleri ve kontrol grubu ile karşılaştırıldığında anlamlı olarak azaldığı saptandı. Böbrek üst, orta ve alt segmentlerinin ortalama dansite değerleri benzerdi. Elde edilen bu bulguların insanlarda üreter obstrüksiyonun sonuçlarının değerlendirilmesinde yararlı olabileceğini düşünmekteyiz. KÇKBT değerlendirilmesinde renal parankim dansitesinin azalması renal parankimal hasarın bir göstergesi olabilir.J. Exp. Clin. Med., 2012; 29:215-220 It is well known that a prolonged ureteral obstruction leads to function loss of the congested kidney. Determining whether kidney stones cause any obstruction by noncontrast multislice CT is crucial for deciding about the timing of treatment. In our study we evaluated by Non-Contrast Multislice Computed Tomography (NCMSCT) detectable reliable changes of the density of the renal parenchyma in rats with artificial hydronephrosis. We made total or partial obstruction to left ureters of Spraque-Dawley rats, and applied sham operation to control groups. Using NCMSCT we measured the renal average parenchyma densities in the first, third and thirteenth days of operation. There was no significant difference between the parenchyma density of partial obstructed group and control group. However the parenchyma density in totally obsructed kidneys has significantly decreased compared to the contralateral kidneys and control group. In this group the duration of the obstruction correlated with signifıcantly decreased parenchyma density. The average density values of the upper, middle and lower renal segments were similar. We assume that our results can be useful in the evaluation of the consequences of the ureteral obstruction. The decrease of the parenchyma density evaluated in NCMSCT could be an important indicator of the renal parenchymal damages.

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Diagnostic value of renal parenchymal density difference on unenhanced helical computed tomography scan in acutely obstructing ureteral stone disease

Cited by 15 publications

References 12 publications

Noncontrast Ct Findings for Spontaneous Passage of Ureteral Stones

Noncontrast Ct Findings for Spontaneous Passage of Ureteral Stones

Secondary signs on preoperative CT as predictive factors for febrile urinary tract infection after ureteroscopic lithotripsy

Evaluation of hydronephrotic kidney parenchymal density by non-contrast multislice computed tomography

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