Non-contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in the patients with refractory renal colic
| Autor: | Lina Linov, Clara L. Dosoretz Ben-Horin, Ronit Peled, Octavian Leibovici, Eugeny Stepnov, Sergey Kravchick, Shmuel Cytron, Valery Lebedev, Leonardo Trejo |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Colic Urinary Bladder Flank Pain Scintigraphy Kidney Sensitivity and Specificity Sex Factors Refractory Predictive Value of Tests medicine Humans Radiology Nuclear Medicine and imaging Renal colic Prospective Studies Prospective cohort study Radionuclide Imaging Aged medicine.diagnostic_test business.industry Reproducibility of Results General Medicine Emergency department Middle Aged Clinical trial medicine.anatomical_structure Predictive value of tests Female Kidney Diseases Urinary Calculi Radiology medicine.symptom Ureter business Tomography X-Ray Computed Algorithms |
| Zdroj: | European journal of radiology. 58(2) |
| ISSN: | 0720-048X |
| Popis: | To assess the importance of combined use of non-contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in evaluation of patients with refractory flank pain in the emergency department.The study involved 64 consecutive patients with refractory renal colic. All patients were evaluated with plain abdominal films kidneys, ureters and bladder (KUB), NCCT and DRS. We assessed the accuracy of different diagnostic procedures and their combinations; in addition, we determined their importance for different steps of evaluation.Urololithiasis was diagnosed in 76.6% (n=49) of the patients. Twenty-nine percent of calculi were4 mm. Surgical intervention were performed in 20 patients (40.8%). A combination of NCCT plus DRS yielded the greatest sensitivity (96%) in establishing final diagnosis, however clinical, laboratory and KUB data in combination with DRS, yielded greater specificity (93%) and PPV (97%). Sex (male), WBC (mean 10.2 x 10(3) +/- 3.1) and KUB (calculus4 mm) were chosen in the three-step multi-variant analysis, while only male sex was found to be the strongest predictor (p0.056) of necessity to perform NCCT. In making decision for definitive treatment NCCT and DRS provided the most important information about stone size and obstruction (kappa=0.734, p0.001 and kappa=0.625, p0.001), while DRS was selected as the most important diagnostic procedure in the emergency department (kappa=0.527, p0.001).In the emergency department, DRS combined with the results of clinical investigation may indicate candidates for hospitalization with emergency intervention. Immediate NCCT must be strongly considered in men with WBCor =10 x 10(3) and calculi4 mm on the KUB. |
| Databáze: | OpenAIRE |
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