التفاصيل البيبلوغرافية
| العنوان: |
Imaging strategies for patients with suspicion of uncomplicated colic pain: diagnostic accuracy and management assessment. |
| المؤلفون: |
Faget, Claire, Millet, Ingrid, Sebbane, Mustapha, Thuret, Rodolphe, Verheyden, Cécile, Curros-Doyon, Fernanda, Molinari, Nicolas, Taourel, Patrice |
| المصدر: |
European Radiology; May2021, Vol. 31 Issue 5, p2983-2993, 11p, 1 Diagram, 3 Charts, 2 Graphs |
| مصطلحات موضوعية: |
RENAL colic, COMPUTED tomography, COLIC, ULTRASONIC imaging, SUSPICION, DIAGNOSIS |
| مستخلص: |
Objective: Compare different imaging scenarios in the diagnosis of uncomplicated renal colic due to urolithiasis (URCU). Materials and methods: A total of 206 prospectively included patients had been admitted with suspected URCU and had undergone abdominal plain film (APF), US and unenhanced CT after clinical STONE score evaluation. CT was the reference standard. We assessed sensitivity (Se), specificity (Spe) and Youden index for colic pain diagnosis, percentage of patients managed by urologic treatment with stone identified, percentage of alternative diagnoses (AD) and exposure to radiation, according to single imaging approaches, strategies driven by patient characteristics and conditional imaging strategies after APF and US. Results: One hundred (48.5%) patients had a final diagnosis of URCU and 19 underwent urologic treatment. The conditional strategy, i.e. CT in patients who had no stone identified at US, had a perfect sensitivity and specificity. This enabled diagnosis of all stones requiring urology management while decreasing the number of CT exams by 22%. The strategy whereby CT was used when there was neither direct or indirect APF + US finding of colic pain nor alternative diagnoses in patients with a STONE score ≥ 10 had a sensitivity of 0.95 and a specificity of 0.99, identified 84% of stones managed by urologic treatment and decreased the number of CT examinations by 76%. Conclusion: In patients with clinical findings consistent with URCU, the use of ultrasound as first-line imaging modality, with CT restricted to patients with negative US and a STONE score ≥ 10, led to a sensitivity and specificity of above 95%, identified 84% of stones requiring urological management and reduced the number of CT scans needed by fourfold. Key Points: • For diagnosis, the use of APF + US as first-line imaging, with CT restricted to patients with both a normal APF + US and a STONE score ≥ 10, provides both a sensitivity and specificity superior or equal to 95% and reduces the number of CT scans necessary by fourfold. • For management, the use of APF + US as first-line imaging, with CT restricted to patients with both a normal APF + US and a STONE score ≥ 10, maintains a 84% stone identification rate in urology-treated patients. [ABSTRACT FROM AUTHOR] |
|
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
