Role of Dual-Energy Computed Tomography in Characterization of Ureteric Calculi and Urinary Obstruction
Autor: | Poonam Yadav, Anchal Singh, Sachin Khanduri, Nazia Khan, Ahmad Umar Khan, Mushahid Husain, Shreshtha Jain, Mazhar Khan |
---|---|
Rok vydání: | 2020 |
Předmět: |
Urology
Mixed type Ct urography 030204 cardiovascular system & hematology urologic and male genital diseases Adipose capsule of kidney 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine ureteric calculi chemical composition Medicine business.industry Significant difference General Engineering Dual-Energy Computed Tomography obstruction Urinary obstruction chemistry General Surgery Uric acid Ultrasonography Radiology business Nuclear medicine 030217 neurology & neurosurgery dual energy ct |
Zdroj: | Cureus |
ISSN: | 2168-8184 |
Popis: | Objective The present study was carried out to assess the accuracy of dual-energy computed tomography (DECT) in the morphological and chemical characterization of ureteric calculi along with the prediction of the grade of urinary obstruction. Methods This was a prospective observational study that included 100 cases with ultrasonography (USG)-diagnosed ureteric calculi that underwent surgery or had spontaneous expulsion of ureteric calculi. At enrolment, DECT was performed for an in vivo evaluation of volume, chemical composition, and grade of obstruction by subjective assessment of the perinephric edema. After surgical intervention, in vitro evaluation of volume was done by fluid displacement followed by infrared spectroscopy (IRS) for chemical composition. DECT findings were compared with the biochemical analysis and degree of obstruction was validated against excretory CT urograms. Sensitivity, specificity, and the positive predictive and negative predictive values of DECT were assessed. Results No significant difference was observed between the mean volume of stones by fluid displacement (65.1±77.61 mm3) and DECT assessment (66.09±81.78 mm3). IRS revealed the composition of stones as hydroxyapatite, uric acid, cysteine, oxalic acid, and mixed type in 48, 23, 15, five, and nine cases. The sensitivity and specificity of DECT for hydroxyapatite, uric acid, cysteine, oxalic acid, and mixed types were 89.6% and 88.5%, 82.6% and 97.5%, 86.7% and 96.5%, 80% and 98.9%, and 88.9% and 98.9%, respectively. On CT urography, a total of 35 had a high-grade and 65 had a low-grade obstruction, whereas DECT revealed high- and low-grade obstructions in 42 and 58 cases. The sensitivity and specificity of DECT for a high-grade obstruction were 94.3% and 86.2%. Conclusions The findings of the study showed that DECT provides comprehensive information regarding the morphological, chemical, and anatomical characterization of ureteric stones. |
Databáze: | OpenAIRE |
Externí odkaz: |