Document Detail


Relationship between duration of pain and secondary signs of obstruction of the urinary tract on unenhanced helical CT.
MedLine Citation:
PMID:  11461855     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study was to investigate the relationship between duration of flank pain and the frequency of secondary signs of ureteral obstruction on unenhanced helical CT. SUBJECTS AND METHODS: The duration of flank pain was prospectively determined in 227 consecutive patients diagnosed with acute ureterolithiasis on unenhanced helical CT. These CT studies were evaluated for the presence or absence of perinephric stranding, ureteral dilatation, perinephric fluid, collecting system dilatation, periureteral stranding, and nephromegaly. The frequency of each sign was determined as a function of the duration of pain. RESULTS: The frequency of moderate or severe perinephric stranding increased from 5% at 1--2 hr to 51% at 7--8 hr (p < 0.001); ureteral dilatation increased from 84% at 1--2 hr to 97% at more than 8 hr (p < 0.03); moderate or severe perinephric fluid increased from 0% at 1--2 hr to 22% at 3--4 hr (p < 0.03); collecting system dilatation increased from 68% at 1--2 hr to 89% at 7-8 hr (p < 0.03); periureteral stranding increased from 35% at 1--2 hr to 76% at 7--8 hr (p < 0.004); and nephromegaly increased from 40% at 1--2 hr to 54% at 7--8 hr (p < 0.36). CONCLUSION: All CT secondary signs of ureteral obstruction except nephromegaly showed a significant increase in frequency as duration of flank pain increased. This observation may explain why the CT studies of some patients with acute ureterolithiasis show negative findings for some or all CT secondary signs of obstruction. Therefore, knowledge of the duration of pain is important when interpreting unenhanced CT studies in patients with acute ureterolithiasis.
Authors:
M J Varanelli; D M Coll; J A Levine; A T Rosenfield; R C Smith
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  177     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-07-19     Completed Date:  2001-08-30     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  325-30     Citation Subset:  AIM; IM    
Affiliation:
Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Male
Pain / etiology*,  physiopathology
Prospective Studies
Time Factors
Tomography, X-Ray Computed / methods*
Ureteral Calculi / complications,  radiography*
Ureteral Obstruction / complications,  radiography*

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