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2016 ; 13
(11
): 654-662
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An overview of kidney stone imaging techniques
#MMPMID27578040
Brisbane W
; Bailey MR
; Sorensen MD
Nat Rev Urol
2016[Nov]; 13
(11
): 654-662
PMID27578040
show ga
Kidney stone imaging is an important diagnostic tool and initial step in deciding
which therapeutic options to use for the management of kidney stones. Guidelines
provided by the American College of Radiology, American Urological Association,
and European Association of Urology differ regarding the optimal initial imaging
modality to use to evaluate patients with suspected obstructive nephrolithiasis.
Noncontrast CT of the abdomen and pelvis consistently provides the most accurate
diagnosis but also exposes patients to ionizing radiation. Traditionally,
ultrasonography has a lower sensitivity and specificity than CT, but does not
require use of radiation. However, when these imaging modalities were compared in
a randomized controlled trial they were found to have equivalent diagnostic
accuracy within the emergency department. Both modalities have advantages and
disadvantages. Kidney, ureter, bladder (KUB) plain film radiography is most
helpful in evaluating for interval stone growth in patients with known stone
disease, and is less useful in the setting of acute stones. MRI provides the
possibility of 3D imaging without exposure to radiation, but it is costly and
currently stones are difficult to visualize. Further developments are expected to
enhance each imaging modality for the evaluation and treatment of kidney stones
in the near future. A proposed algorithm for imaging patients with acute stones
in light of the current guidelines and a randomized controlled trial could aid
clinicians.
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