Document Detail


Advanced imaging in stone management.
MedLine Citation:
PMID:  15075837     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Stone disease continues to plague humankind. Recent innovations in minimally invasive surgery, however, have decreased morbidity for the treatment of lithiasis, once only amenable to open surgical techniques. These advances in stone management have also been paralleled in the radiographic armamentarium. Herein, we describe the evolution of initial radiographic workup for urolithiasis, from abdominal radiograph to three-dimensional computed tomography and some of the novel applications thereof. RECENT FINDINGS: Previously, abdominal radiography was the only modality available for the visualization of calculi. Subsequently, the development of intravenous contrast aided in evaluating renal function, detecting the presence and location of obstruction, and in identifying filling defects. Most recently, prospective randomized trials have demonstrated improved sensitivity and specificity using noncontrast helical computed tomography rather than intravenous pyelogram with regard to the initial evaluation of acute flank pain. Further attempts to lower the overall radiation dose without compromising efficacy have also been introduced. Currently, the volume of calculus disease can be better quantified and somewhat qualified from three-dimensional computer software, thereby optimizing stone management. SUMMARY: Considerable progress has been made using minimally invasive techniques in the treatment of nephrolithiasis. Furthermore, advances in radiographic computer hard- and software applications allow for a rapid acquisition time and improved image quality without sacrificing diagnostic accuracy. In time, it is likely that the combination of these enhanced imaging modalities will lead to an improvement in stone localization, fragmentation and stone-free rates.
Authors:
W Patrick Springhart; Glenn M Preminger
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in urology     Volume:  14     ISSN:  0963-0643     ISO Abbreviation:  Curr Opin Urol     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-04-12     Completed Date:  2004-05-20     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9200621     Medline TA:  Curr Opin Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  95-8     Citation Subset:  IM    
Affiliation:
The Comprehensive Kidney Stone Center, Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Flank Pain / etiology,  radiography
Humans
Imaging, Three-Dimensional
Tomography, X-Ray Computed*
Urinary Calculi / complications,  radiography*

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