Urinary Tract Abnormalities: Initial Experience with Multi–Detector Row CT Urography

Caoili, Elaine M.; Cohan, Richard H.; Korobkin, Melvyn; Platt, Joel F.; Francis, Isaac R.; Faerber, Gary J.; Montie, James E.; Ellis, James H.

doi:10.1148/radiol.2222010667

Cited by 263 publications

(143 citation statements)

References 17 publications

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“…12 The radiation exposure of low-dose unenhanced CT is only slightly higher than KUB radiography and significantly lower than regular-dose unenhanced CT (1-1.9 v. 0.5-1 v. 4.5-5 mSv, respectively). 16,24,25 Lowdose unenhanced CT appears to have emerged as the imaging modality of choice given its very low radiation, diagnostic performance similar to that of regular-dose unenhanced CT, and significantly better diagnostic performance than KUB/ultrasonography. 17 Finally, although the population with the greatest concerns regarding radiation exposure is women, this also appears to be the population with the highest rate of alternative diagnosis.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Cumulative evidence from a number of studies suggests that three-phase CT scan exposes patients to approximately two to three times as much radiation as approximately 12 plain film radiographs (though not that many be required) taken during the course of intravenous pyelography (IVP). [97,98,99] More advanced CT protocols, namely multiphase protocols, have made this issue of more significant concern. Possibilities for limiting radiation in these studies include eliminating a phase (which may then limit examination accuracy) or reducing mA during some of the phases of the study.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Radiologic Imaging of Renal Masses

Bird¹,

Bird²

2011

Renal Cell Carcinoma

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“…A TC por multidetectores ("multislice") tem sido recentemente apresentada como opção diagnóstica (25,26) . Tack et al (27) avaliaram 106 pacientes com suspeita de có-lica renal por este método, sem a utilização de meio de contraste oral ou venoso.…”

Section: Outras Modalidades Diagnósticasunclassified

Avaliação dos métodos de imagem no diagnóstico da urolitíase: revisão da literatura

et al. 2004

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Freitas RMC et al. Radiol Bras 2004;37(4):291294291 do abdome associada à ultra-sonografia (US) são apropriadas na abordagem diagnóstica da dor lombar aguda e podem ser utilizadas como métodos alternativos quando recursos como a TC helicoidal são limitados (2) . O objetivo deste trabalho é revisar a literatura sobre o tema, abordando as opções e as perspectivas diagnósticas. A literatura publicada nos últimos 30 anos comparando os métodos atualmente disponí-veis para a avaliação de pacientes com dor lombar aguda foi revisada, com atenção aos seguintes métodos: a radiografia simples de abdome, a UE, a US e a TC helicoidal. O objetivo deste trabalho foi comparar a tomografia computadorizada helicoidal com os métodos imaginológicos atualmente disponíveis para a abordagem dos pacientes com dor lombar aguda e revisar brevemente as características fisiopatológicas da urolitíase e a evolução da sua abordagem diagnóstica. Foi revista a literatura publicada nos últimos 30 anos, comparando os seguintes métodos: radiografia simples de abdome, urografia excretora, ultra-sonografia e tomografia computadorizada helicoidal. Esta última se mostrou mé-todo de alta sensibilidade e especificidade para o diagnóstico de urolitíase, sendo que, virtualmente, todos os cálculos são identificados por este método, exceto em pacientes em uso de indinavir. A radiografia simples de abdome associada à ultra-sonografia têm acurácia semelhante à tomografia computadorizada helicoidal, contudo, esta foi superior como método de avaliação isolado. A literatura sugere que a tomografia computadorizada helicoidal é útil na avaliação de pacientes com dor lombar aguda quando disponível, possibilitando também o diagnóstico diferencial entre as várias doenças que simulam os sintomas de urolitíase. Unitermos: Dor lombar aguda; Radiografia simples do abdome; Tomografia computadorizada helicoidal; Ultrasonografia do trato urinário; Urografia excretora; Urolitíase. DISCUSSÃOEvaluation of imaging methods in the diagnosis of urolithiasis: review of the literature. The aim of this study is to compare helical computed tomography with imaging studies currently used to evaluate patients with acute low back pain. In addition, we briefly review the pathophysiology of urolithiasis. The literature published in the last 30 years was reviewed, and the following methods were discussed: plain abdominal radiographs, intravenous pielography, ultrasound of the urinary tract, and helical computed tomography. Helical computed tomography showed high sensitivity and specificity for detecting urolithiasis, virtually showing all stones, except in patients receiving indinavir. The accuracy of plain abdominal radiographs associated with ultrasound was similar to helical computed tomography, although the latter showed superiority as an isolated method. Data from literature suggest that whenever helical computed tomography is available, it is helpful in the evaluation of low back pain and also allows differential diagnosis between conditions that mimic the symptoms of urolithiasis. Key...

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Urinary Tract Abnormalities: Initial Experience with Multi–Detector Row CT Urography

Abstract: Multi-detector row CT urography is a useful method for detecting urinary tract abnormalities.

Cited by 263 publications

References 17 publications

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

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

Radiologic Imaging of Renal Masses

Avaliação dos métodos de imagem no diagnóstico da urolitíase: revisão da literatura

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