Unenhanced Helical Computed  Tomography in the Evaluation of  Acute Flank Pain

Hamm, Michael W.; Wawroschek, Friedhelm; Weckermann, Dorothea; Knöpfle, E.; Hackel, Thomas; Häuser, H.; Krawczak, Gunnar; Harzmann, R.

doi:10.1159/000052486

Cited by 69 publications

(33 citation statements)

References 22 publications

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“…Direkt üriner sistem grafisi (DÜSG), radyologlar tarafından değerlendirildiğinde sensitivitesi %48-62 arasında iken (11)(12)(13)(14), acil doktorları tarafından değerlendirildiği bir çalışmada DÜSG sensitivitesinin %29'lara kadar düştüğü bildirilmiştir (15). DÜSG spesifitesi ise %60-77 olarak hesaplanmıştır (16 (24,25). İlk kez 1995 yılında Smith ve arkadaşları (26) tarafından yararının belirtilmesinden bu yana, BT kullanılarak yapılan çalışmalarda üriner taşların tanısında yük-sek sensitivite (%95-98) ve spesifite (%96-100) oranları bulunmuş-tur (27)(28)(29)(30).…”

Section: Discussionunclassified

Comparison of Non Enhanced Computed Tomography with Ultrasound in Patients with Renal Colic

Çakıroğlu¹,

Eyupoglu²,

Hazar³

et al. 2013

JAREM

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ÖZETAmaç: Acil servise yan ağrısı ile başvuran hastalarda spiral bilgisayarlı tomografi (BT) ile ultrasonografinin (USG) üreter taşını göstermedeki tanısal etkinliğini karşılaştırmayı amaçladık.Yöntemler: Ocak 2012 ile Haziran 2012 tarihleri arasında acil servise ve üroloji polikliniğine tek ya da iki taraflı yan ağrısı, karın ağrısı,kasık ağrısı şikayeti ile başvuran ve renal kolik olduğu şüphelenilen hastalar retrospektif olarak incelenerek çalışmaya dahil edildi. Hastaların yapılan ultrason, tomografi ve tam idrar tetkikleri incelendi. Ultrason yapılıp taş tespit edilemeyen ve sonra tomografi yapılan hastalar çalışmaya alındı.Bulgular: Çalışmaya dahil edilen 138 hastanın yaşları ortalaması 35,3±10,8 (7-68), taş çapları 6,12±2,68 (3-17) mm, taş çapına göre ayrılan Grup 1'de 63 hasta yaş ortalaması 33,1±10,7 ve taş çapı ortalaması 3,93±0,98 mm olarak bulundu. Grup 2'de 75 hastanın yaş ortalaması 37,1±10,9 ve taş çapı ortalaması 7,96±2,24 mm idi. Grup 1'de BT'nin sensivitesi %96 (72/75) ve ultrasonun sensivitesi %56 (76) olarak bulundu. Grup 2'de BT'nin sensivitesi %97 (/63) ve ultrasonun sensivitesi %64 (63) tespit edildi. Taşların bulunduğu anatomik lokalizasyonuna göre gruplamada A grubunda (böbrekler) 47 hastanın yaşları ortalaması 36,0±9,4 ve taş çapları 5,52±0,43 mm, B grubunda (pelvis ve üst üreter) 23 hastanın yaşları ortalaması 38,10±11,1 ve taş çapları 7,87±1,98, C grubunda (orta üreter) 25 hastanın yaşları ortalaması 34,5±10,2 ve taş çapları 6,02±1,33 mm, D grubunda (alt üreter) 43 hastanın yaş ortalaması 33,4±11,9 ve taş çapları 5,86±2,33 mm idi.Sonuç: Bilgisayarlı tomografi acil servise renal kolik şikayeti ile başvuran hastalardaki üriner sistem taşlarını tespit etmede USG'den daha etkilidir. Bununla birlikte, yatak başı kullanılan ve invazif olmayan USG, acil servislerde üriner taşların tespitinde ilk seçenek olarak kullanılabilir. Bilgisayarlı tomografi, ultrason sonucu negatif gelen hastalar için kullanışlı olabilir. (JAREM 2013; 3: 31-5) Anahtar Sözcükler: Spiral bilgisayarlı tomografi, ultrasonografi, üreter taşı, renal kolik ABSTRACT Objective: The aim of the study is to compare the efficacy of non enhanced computed tomography (NECT) with ultrasound (US) imaging in the assessment of ureteral stone in patients admitted to emergency department with flank pain.Methods: Between January 2012 and June 2012, the data of patients admitted to the urology outpatient clinic or emergency department with uni or bilateral flank and/or groin pain were included in the study. The data of US, NECT and urinanalysis were retrospectively reviewed. Patients whose stones were not detected on US examination and refered to NECT examination were included in the study. Results:The mean age and stone size of the 138 patients included in the study were 35.3±10.8 (7-68), 6.12±2.68 (3-17), respectively. The patients were distributed according to stone size; the mean age, stone size of 63 patients in group I and group II were 33.1±10.7, 3.93±0.98 mm and 37.1±10.9, 7.96±2.24 mm respectively. NECT, US sensitivities in Grou...

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Section: Discussionunclassified

Comparison of Non Enhanced Computed Tomography with Ultrasound in Patients with Renal Colic

Çakıroğlu¹,

Eyupoglu²,

Hazar³

et al. 2013

JAREM

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“…However, HCT also has some pitfalls such as difficulty in the diagnosis of lower and small ureteral stones particularly in the absence of ureteral dilatation, and stones in very thin individuals with little adipose tissue [1-3, 5, 8]. Besides these disadvantages, the superiority of HCT over EU in terms of radiation exposure is controversial [1,3].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, although the sensitivity and specificity values of USG, EU, and Ur are generally lower than those of HCT in the recent literature, they may have some advantages over HCT [1,3,6]. For example, USG is a relatively cheap and widespread imaging method easily and noninvasively performed without radiation exposure in pregnant females and individuals with allergy to contrast material.…”

Section: Discussionmentioning

confidence: 99%

“…Because HCT has many advantages, such as short examination time and usage without contrast material, it is commonly used as a first-line examination method in the evaluation of urinary stone disease at many centers [1][2][3][4][5]. To date, the reported diagnostic parameters of HCT vary from 94 to 100% for sensitivity, from 96 to 100% for specificity, and from 96 to 100% for accuracy [1,6,7].…”

Section: Introductionmentioning

confidence: 99%

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Can Conventional Examinations Contribute to the Diagnostic Power of Unenhanced Helical Computed Tomography in Urolithiasis?

Unal

Yeni²,

Karaoğlanoğlu³

et al. 2003

Urol Int

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Introduction: To investigate whether ordinary tests used in urolithiasis can increase the diagnostic value of unenhanced helical computed tomography (HCT). Materials and Methods: Of all patients admitted with acute flank pain, 137 without radiocontrast allergy, pregnancy and renal insufficiency were included in the study. After urinalysis (Ur) and ultrasonography (USG), HCT without a contrast agent was taken by 5-mm collimation, thereafter excretory urography (EU) was obtained. Confirmation of a stone was done by various tests and/or treatment methods. Statistically, the predictive values of HCT, USG, EU and Ur and their combinations were evaluated using the area under the receiver operating characteristic curve (AROC). Results: The patients’ mean age was 38 (range 4–72) years. Sensitivity values of HCT, USG, EU and Ur were 97, 69, 71 and 81%, respectively. Their specificity values were 96, 87, 91 and 65%, respectively. The widest AROC was found for HCT (97%). The best test combination was [HCT or USG] according to the AROC value (93%), but none of the AROC values of the test combinations was higher than that of HCT. However, 95% confidence intervals of the AROC values of these tests and their combinations overlapped. Conclusions: Because the HCT combinations with other tests improved the diagnostic value of HCT, they should be preferred in some individuals suspected of having urolithiasis. However, the most feasible single test meeting the all usage purposes was HCT in terms of the AROC value, and the combination was [HCT or USG] in which either HCT or USG was positive.

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“…Çok küçük ve non-opak taşları dahi saptayabilir. Böbrek taş hastalığı için en doğru ve güvenilir yöntemdir (duyarlılığı %94-100, özgüllüğü %92-99) 26,27,29,31,32 .…”

Section: Renal Kolik Tanısıunclassified

Acil Serviste Renal Kolikli Hasta Yönetimi

Ay¹,

Avcı²,

Acehan³

et al. 2014

Arşiv Kaynak Tarama Dergisi

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Renal colic is a common emergent urological problem seen in emergency departments, which often occurs due to kidney stone disease and characterized by severe pain. Renal colic is described by the patients as the most painful and debilitating experience of their life. The main purpose of emergency treatment is to control pain effectively, and resolve urinary obstruction without causing loss of renal function. In this compilation, studies regarding the management of patients with renal colic in emergency department are reviewed.

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Unenhanced Helical Computed Tomography in the Evaluation of Acute Flank Pain

Cited by 69 publications

References 22 publications

Comparison of Non Enhanced Computed Tomography with Ultrasound in Patients with Renal Colic

Comparison of Non Enhanced Computed Tomography with Ultrasound in Patients with Renal Colic

Can Conventional Examinations Contribute to the Diagnostic Power of Unenhanced Helical Computed Tomography in Urolithiasis?

Acil Serviste Renal Kolikli Hasta Yönetimi

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