Utility of enhanced CT for patients with suspected uncomplicated renal colic and no acute findings on non-enhanced CT
| Autor: | C. Robert, A. Paisant, Y. Gandon, B. Peyronnet, S. Gauthier, Christophe Aubé |
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| Přispěvatelé: | Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], CHU Pontchaillou [Rennes], Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service des urgences [Rennes] = Emergency [Rennes], Université d'Angers (UA) |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Leukocytosis [SDV]Life Sciences [q-bio] Iohexol Renal function Contrast Media Kidney Function Tests 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Internal medicine medicine Clinical endpoint Humans Radiology Nuclear Medicine and imaging Renal colic Young adult Renal Colic Urinary Tract Aged Retrospective Studies Aged 80 and over Observer Variation business.industry Retrospective cohort study General Medicine Emergency department Middle Aged Institutional review board Confidence interval 3. Good health 030220 oncology & carcinogenesis Creatinine Female medicine.symptom business Emergency Service Hospital Tomography X-Ray Computed |
| Zdroj: | Clinical Radiology Clinical Radiology, WB Saunders, 2019, 74, pp.813.e11-813.e18. ⟨10.1016/j.crad.2019.06.007⟩ |
| ISSN: | 1365-229X 0009-9260 |
| DOI: | 10.1016/j.crad.2019.06.007⟩ |
| Popis: | AIM To evaluate the utility of contrast-enhanced computed tomography (CECT) for patients with suspected uncomplicated renal colic (URC) and no abnormalities on non-enhanced computed tomography (NECT). MATERIALS AND METHODS The hospital institutional review board and ethics committee approved this retrospective study with a waiver of informed consent. Between January 2016 and April 2017, all consecutive adult patients who consulted at the adult Emergency Department (ED) with suspected URC and who had undergone both NECT and CECT were included retrospectively. The primary endpoint was prevalence of CECT-only diagnosis without acute findings on NECT. The risk factors for an acute finding were identified by logistic regression analysis. RESULTS Among 126 patients with suspected URC, 12 were excluded. Among the 76 patients with no acute findings on NECT, CECT led to find acute lesions in 14/76 (18%) cases, but only 2/76 (3%) resulted in a change of management. Predictive factors of abnormal finding on CECT were: low renal clearance and high leukocyte count with OR 0.96 (95% confidence interval [CI]: 0.93–0.99), p=0.0189 and OR 5.79 (95% CI: 1.55–21.64), p=0.0091, respectively. CONCLUSIONS In most cases, NECT is sufficient for screening patients with suspected URC. If leucocytosis and low renal function are present, stronger consideration may be given to CECT. |
| Databáze: | OpenAIRE |
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