Document Detail


A critical appraisal of the radiological evaluation of nephrocalcinosis.
MedLine Citation:
PMID:  17522474     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIM: The level of agreement concerning the diagnosis of nephrocalcinosis (NC) based on ultrasonography (US), computed tomography (CT) or kidney/ureter/bladder (KUB) X-ray was assessed. METHODS: Sequences of KUB+US+CT from 62 patients, 48 with at least one exam suggesting NC and 14 with pelvicalyceal calcifications (nephrolithiasis) were reviewed twice by 3 radiologists (firstly randomized and secondly presenting KUB+US+CT of each patient together). RESULTS: The intraobserver concordance varied from 76 to 90% for KUB, 77 to 85% for US and 82 to 89% for CT. There was a significant change in diagnosis between the 1st and 2nd reviews for observer 1 in KUB and CT, for observer 2 in US, but not for observer 3. Evaluating patients' exams together did not provide a better agreement. The highest sensitivity and specificity (92 and 89%, respectively) were only attained when 2 exams suggested NC diagnosis, being CT one of them. These enabled us to suggest that 33 out of 48 (62.5%) patients had NC (evidenced in US+CT+KUB (81.8%), US+CT (12.1%) or KUB+CT (6.1%). CONCLUSION: The low level of concordance renders the radiological diagnosis of NC difficult. Nephrocalcinosis should be confirmed by CT combined with either US or KUB.
Authors:
Lara Cheidde; Sérgio Aron Ajzen; Cecilia Helena Tamer Langen; Dejaldo Christophalo; Ita Pfeferman Heilberg
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-05-22
Journal Detail:
Title:  Nephron. Clinical practice     Volume:  106     ISSN:  1660-2110     ISO Abbreviation:  Nephron Clin Pract     Publication Date:  2007  
Date Detail:
Created Date:  2007-07-13     Completed Date:  2007-09-28     Revised Date:  2007-11-19    
Medline Journal Info:
Nlm Unique ID:  101159763     Medline TA:  Nephron Clin Pract     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  c119-24     Citation Subset:  IM    
Copyright Information:
Copyright 2007 S. Karger AG, Basel.
Affiliation:
Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Female
Humans
Male
Metabolic Diseases / diagnosis,  etiology
Middle Aged
Nephrocalcinosis / complications,  radiography*,  ultrasonography
Observer Variation
Sensitivity and Specificity

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