Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography.

Sourtzis, Stavroula; Thibeau, Jean François; Damry, Nasroolla; Raslan, Ahmed M.; Vandendris, Michel; Bellemans, Marie Anne

doi:10.2214/ajr.172.6.10350278

Cited by 186 publications

(95 citation statements)

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“…CT scan equals the accuracy of the IVP in determining the presence of obstruction, but surpasses the IVP in terms of detecting the specific cause of the obstruction. 1,16 In our study, CT scan was done in three patients as the urea creatinine were more >2mg/dl and in these patients IVP was not possible. MRI gives no added advantage over CT scan and it does not visualise the stones.…”

Section: Discussionmentioning

confidence: 96%

“…Urinary stones can be classified on the basis of their size, location, X-ray characteristics, aetiology, composition (Mineralogy) and risk groups for recurrent stone formation. 1 Ultrasonography is used as primary modality in diagnosing this disease. A renal contrast study (Enhanced CT or Intravenous Urography) is indicated while planning treatment for a renal stone in addition to assess the function of the affected kidney.…”

Section: Introductionmentioning

confidence: 99%

“…A renal contrast study (Enhanced CT or Intravenous Urography) is indicated while planning treatment for a renal stone in addition to assess the function of the affected kidney. [1][2][3] Biochemical investigations like urea, electrolytes and creatinine are used to assess the renal functions whereas whole blood examination and midstream urine microscopic culture and sensitivity are used to diagnose sepsis. 4 Gamma-camera renography using I-hippuran or 99mTc-DTPA objectively analyses the accumulation, transit and elimination of injected activity by each kidney to produce the well-known time-activity curves.…”

Section: Introductionmentioning

confidence: 99%

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Radiological Investigations, Biochemical Renal Function Tests and the Changes After Surgery in Renal Calculus Obstructive Uropathy

Gupta¹,

Saini²,

Gupta³

et al. 2016

jemds

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Urolithiasis has affected the mankind for long years. These stones cause progressive renal impairment. These patients usually present with characteristic loin pain, vomiting, and sometimes fever. Patients may also be asymptomatic at times. Urinary stones can be classified on the basis of their size, location, X-ray characteristics, aetiology, composition (Mineralogy) and risk groups for recurrent stone formation. AIMS AND OBJECTIVESTo evaluate the Preoperative and postoperative radiological and biochemical changes in renal calculus obstructive uropathy in patients with cortical thickness of minimum 4mm. MATERIAL AND METHODSAll patients who were admitted in Department of Surgery, Rama Medical College Hospital and Research Centre, Kanpur, UP with diagnosis of obstructive uropathy due to stone disease and operated upon were included in this study. RESULTSAfter 1 month and 3 months the relief in obstruction was studied by repeating the tests. It was found that urea, creatinine levels took about 3 months to get normalized. USG and IVP at 3 months showed complete normalization of hydronephrosis, however, at one month few cases still had hydronephrosis. CONCLUSIONUrea, creatinine levels along with USG and IVP form the basis of detection and management of obstructive uropathy. CT scan has a definitive role in few cases where urea creatinine levels are on higher side. Renal scan is mandatory in the cases of delayed/nonfunctioning on IVP. Nephrectomy should not be done without assessment of renal function (%) on renal scan. After definitive management of relief of obstruction by various methods, it takes about three months for normalization of kidney function. KEYWORDSUrea, Creatinine, Ultrasonography, Intravenous Pyelography, Renal Scan, Renal Stone. HOW TO CITE THIS ARTICLE:Gupta M, Saini P, Gupta P, et al. Radiological investigations, biochemical renal function tests and the changes after surgery in renal calculus obstructive uropathy.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Radiological Investigations, Biochemical Renal Function Tests and the Changes After Surgery in Renal Calculus Obstructive Uropathy

Gupta¹,

Saini²,

Gupta³

et al. 2016

jemds

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“…Unenhanced CT has been found to have better diagnostic performance than IVP, with sensitivity and specificity rates over 95%. [3][4][5][6][7][8] These diagnostic performances are also significantly better than a diagnostic approach combining KUB radiography and ultrasonography, particularly for stones less than 5 mm in size. 6,7 For these reasons, the American College of Radiology recommends unenhanced CT as the technique of choice for renal stone imaging, 9 as do the American Urological Association 10 and the European Association of Urology.…”

Section: Ré Sumémentioning

confidence: 99%

Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study

Pernet

Abergel

Parra

et al. 2015

CJEM

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Objectives: Unenhanced computed tomography (CT) has become a standard imaging technique for uncomplicated renal colic in many countries. The appropriate timing of CT imaging has not been established, and guidelines recommend that this imaging be performed between 1 and 7 days of presentation. The primary objective of this study was to determine the prevalence of alternative diagnosis identified with low-dose unenhanced CT in the emergency department (ED) in patients with suspected uncomplicated renal colic. Methods: This prospective single-centre study was carried out in a large university hospital ED. Over a 6-month period, all patients with clinically diagnosed renal colic and a plan to be discharged underwent low-dose unenhanced CT in the ED. Pregnant women, women of childbearing age not willing to have a pregnancy test, and patients who had already undergone diagnostic imaging were excluded. The primary outcome was the number and nature of the alternative diagnosis. Univariate analyses were performed to assess factors associated with the primary outcome. Results: A total of 178 patients were screened, and 155 underwent CT in the ED. The mean age was 42.2 years; 69% were male. The diagnosis of uncomplicated renal colic was confirmed in 118 participants (76%); 27 (17%) had an inconclusive CT scan. Overall, 10 patients (6%; 95% confidence interval [CI] 3-10) had an alternative diagnosis, 5 of whom were subsequently hospitalized. Conclusion: Low-dose unenhanced CT in the ED detects alternative diagnoses in 6% (95% CI 3-10) of patients with suspected uncomplicated renal colic, half of whom are subsequently hospitalized. Our prospective findings, which were similar to those reported in retrospective studies, are a potential argument for a systematic approach to ED imaging in suspected renal colic. Future research involving intervention and control groups would be helpful. RÉ SUMÉObjectif: La tomodensitomé trie (TDM) sans densification est devenue, dans de nombreux pays, une technique d'imagerie courante dans les cas de colique né phré tique sans complications. Toutefois, le moment propice pour faire passer cet examen n'est pas é tabli, et, d'aprè s les lignes directrices, l'examen devrait ê tre effectué entre le premier et le septiè me jour de la consultation. L'é tude avait pour objectif principal de dé terminer la pré valence d'autres diagnostics que celui de colique né phré tique sans complications, posé s dans des cas pré sumé s, à l'aide de la TDM sans densification à faible dose, au service des urgences (SU). Mé thode: Il s'agit d'une é tude prospective, unicentrique, qui a é té mené e dans un SU d'un important centre hospitalier universitaire. Sur une pé riode de 6 mois, tous les patients chez qui un diagnostic clinique de colique né phré tique avait é té posé et pour lesquels la sortie é tait pré vue ont passé une TDM sans densification à faible dose au SU. Les femmes enceintes, celles en â ge de procré er qui ne souhaitaient pas passer un test de grossesse et les patients qui avaient dé jà subi de...

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“…[2][3][4] NCT has become the method of choice for evaluating patients with acute renal colic. [5][6][7][8] Transabdominal ultrasound (US) has the advantages of being universally available, not exposing the patient to radiation and being independent of kidney function.…”

Section: Introductionmentioning

confidence: 99%

Comparison between ultrasound and noncontrast helical computed tomography for identification of acute ureterolithiasis in a teaching hospital setting

et al. 2007

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CONTEXT AND OBJECTIVE: Recent studies have shown noncontrast computed tomography (NCT) to be more effective than ultrasound (US) for imaging acute ureterolithiasis. However, to our knowledge, there are few studies directly comparing these techniques in an emergency teaching hospital setting. The objectives of this study were to compare the diagnostic accuracy of US and NCT performed by senior radiology residents for diagnosing acute ureterolithiasis; and to assess interobserver agreement on tomography interpretations by residents and experienced abdominal radiologists. DESIGN AND SETTING: Prospective study of 52 consecutive patients, who underwent both US and NCT within an interval of eight hours, at Hospital São Paulo. METHODS: US scans were performed by senior residents and read by experienced radiologists. NCT scan images were read by senior residents, and subsequently by three abdominal radiologists. The interobserver variability was assessed using the kappa statistic. RESULTS: Ureteral calculi were found in 40 out of 52 patients (77%). US presented sensitivity of 22% and specificity of 100%. When collecting system dilatation was associated, US demonstrated 73% sensitivity, 82% specificity. The interobserver agreement in NCT analysis was very high with regard to identification of calculi, collecting system dilatation and stranding of perinephric fat. CONCLUSIONS: US has limited value for identifying ureteral calculi in comparison with NCT, even when collecting system dilatation is present. Residents and abdominal radiologists demonstrated excellent agreement rates for ureteral calculi, identification of collecting system dilatation and stranding of perinephric fat on NCT.

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Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography.

Cited by 186 publications

References 6 publications

Radiological Investigations, Biochemical Renal Function Tests and the Changes After Surgery in Renal Calculus Obstructive Uropathy

Radiological Investigations, Biochemical Renal Function Tests and the Changes After Surgery in Renal Calculus Obstructive Uropathy

Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study

Comparison between ultrasound and noncontrast helical computed tomography for identification of acute ureterolithiasis in a teaching hospital setting

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