Alternate or additional findings to stone disease on unenhanced computerized tomography for acute flank pain can impact management
Alternate or additional findings to stone disease on unenhanced computerized tomography for acute flank pain can impact management
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DOI：
10.1016/s0022-5347(05)00987-0
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发表时间：
2006-05-01
影响因子：
6.6
通讯作者：
Thoeny, HC
中科院分区：
文献类型：
--
作者：
Hoppe, H;Studer, R;Thoeny, HC
目的：我们评估急性腰痛和疑似尿路结石患者的非增强CT替代或附加表现的发生率和临床相关性。材料与方法：对1500例因急性侧腹疼痛而行CT平扫检查的患者进行连续研究。记录尿路结石有无及定位情况。根据是否需要立即或延迟治疗，或很少或没有临床重要性，对替代或额外的CT发现进行分类。结果：1500例患者中，尿路结石1035例（69%），其中肾结石309例（30%），输尿管结石377例（36%），以上两种情况349例（34%）。这些患者中有331例（32%）单独发现尿石症，704例（68%）发现其他病理情况。在所有患者中，1064例（71%）有其他或额外的CT表现。在所有患者中，207例（14%）有非结石相关的CT表现，需要立即或推迟治疗，464例（31%）的病理状况不具有临床重要性，393例（26%）的病理状况没有临床相关性。CT正常105例（7%）。结论：急性腰痛患者的非增强CT可以准确诊断尿路结石疾病，也可以为大量患者提供进一步的重要信息，从而导致紧急或延迟治疗。
Purpose: We evaluated the incidence and clinical relevance of alternate or additional findings on unenhanced CT in patients with acute flank pain and suspected urinary calculi.Materials and Methods: A consecutive series of 1,500 patients underwent unenhanced CT due to acute flank pain. The absence or presence of urinary tract calculi and their localization were recorded. Alternate or additional CT findings were classified according to whether they required immediate or deferred treatment, or were of little or no clinical importance.Results: Of the 1,500 patients 1,035 (69%) had urinary tract calculi, including 309 (30%) with nephrolithiasis, 377 (36%) with ureterolithiasis and 349 (34%) with the 2 conditions. Urolithiasis alone was found in 331 of these patients (32%) and additional pathological conditions were noted in 704 (68%). Of all patients 1,064 (71%) had other or additional CT findings. Of all patients 207 (14%) had nonstone related CT findings requiring immediate or deferred treatment, 464 (31%) had pathological conditions of little clinical importance and 393 (26%) had pathological conditions of no clinical relevance. CT was normal in 105 of all patients (7%).Conclusions: Unenhanced CT in patients with acute flank pain allows the accurate diagnosis of urinary stone disease and it can also provide further important information leading to emergency or deferred treatment in a substantial number of patients.