Document Detail


Dual-energy contrast-enhanced computed tomography for the detection of urinary stone disease.
MedLine Citation:
PMID:  18007154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess the value of dual-energy contrast-enhanced computed tomography (CT) imaging for the detection of urinary stone disease using dual-source CT. MATERIALS AND METHODS: Forty consecutive patients (mean age 46.6 +/- 16.2 years, range 27-85 years) suspected of having urinary stone disease underwent dual-source CT of the urinary tract. A 3-phasic CT scan protocol consisting of a standard unenhanced scan, a nephrographic, and an excretory phase of contrast enhancement was performed. The nephrographic phase scan was acquired in the dual-energy mode (80 kV/400 mA and 140 kV/95 mA) allowing reconstruction of virtual unenhanced images. Two blinded readers independently compared standard and virtual unenhanced CT for the number, size, and location of urinary stones. Measurements of anteroposterior abdominal diameters were performed to determine abdominal obesity. RESULTS: Standard unenhanced CT revealed 35 uroliths in 18 of the 40 patients (18 of 40; 45%), virtual unenhanced CT demonstrated 26 uroliths in 15 of the 40 patients (15 of 40; 38%) ([kappa] value 0.89). Three false-negative and no false-positive ratings occurred using virtual unenhanced CT, and false-negative ratings solely occurred in obese patients. Sensitivity, specificity, positive predictive, and negative predictive values for virtual unenhanced CT for the diagnosis of urinary stone disease were 83%, 100%, 100%, and 88%, respectively. CONCLUSIONS: Virtual unenhanced CT images reconstructed from contrast-enhanced dual-energy CT allow detection of urinary stones with good sensitivity and excellent specificity, but sensitivity is decreased in abdominal obese patients.
Authors:
Hans Scheffel; Paul Stolzmann; Thomas Frauenfelder; Thomas Schertler; Lotus Desbiolles; Sebastian Leschka; Borut Marincek; Hatem Alkadhi
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Investigative radiology     Volume:  42     ISSN:  0020-9996     ISO Abbreviation:  Invest Radiol     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-16     Completed Date:  2008-02-25     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  823-9     Citation Subset:  IM    
Affiliation:
Department of Medical Radiology, Institute of Diagnostic Radiology, University of Zurich, Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Calcinosis / diagnosis,  radiography
Contrast Media* / administration & dosage
Diagnosis, Differential
False Negative Reactions
False Positive Reactions
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Tomography, X-Ray Computed* / methods
Urinary Calculi / diagnosis*,  radiography*
Chemical
Reg. No./Substance:
0/Contrast Media

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