Keywords:
Performed at one institution, Cross-sectional study, Retrospective, Inflammation, Calcifications / Calculi, Acute, Diagnostic procedure, Computer Applications-General, Colonography CT, CT-High Resolution, CT-Enterography, CT, Kidney, Emergency, Abdomen, Abdominal Viscera
Authors:
U. S. Umer, S. Alam, A. N. Khan, S. G. Ghaus, M. Abdullah, A. Nawaz, M. Asif, N. Gul; Peshawar/PK
DOI:
10.26044/ecr2020/C-00807
Purpose
OBJECTIVE:
To demonstrate the use of non-contrast CT KUB (stone protocol) in the detection of abdominal pathologies other than stones, whether or not simulating the clinical picture of urolithiasis, and its impact upon patient management.
BACKGROUND & INTRODUCTION:
CT KUB has a higher sensitivity for detecting urolithiasis as compared to X ray KUB. One of the major advantages of CT KUB over plain radiography is its ability to diagnose incidental findings or alternative causes of abdominal pain that can affect health 1. As multidetector CT has come to play a more central role in medical care and as CT image quality has improved, there has been an increase in the frequency of detecting incidental findings, defined as findings that are unrelated to the clinical indication for the imaging examination performed. In the present study we aimed to evaluate the detection of incidental pathologies using 128-slice multidetector (MD) CT and the impact of presence of significant incidental findings (those warranting immediate management) on patient's clinical outcome ( Fig. 1 ).
Fig. 1: CT KUB in a patient with right flank pain. Axial and reformatted images alongwith cropped magnified sections showing features of acute Appendicitis (Arrows). Fluid filled distended appendix is seen in right iliac fossa with periappendiceal fat stranding (better appreciated on sagittal image) and minimal free fluid (better seen on axial image). It is important to compare both iliac fossa, when in doubt. The clue here is the increased diameter of appendix alongwith surrounding soft tissue haze.
It has been observed that non-contrast CT KUB usage has increased and physicians and ER doctors while ordering CT KUB are hoping to find something else if not stones.This study was conducted to determine the incidence and spectrum of significant alternate or incidental diagnosis suggested on MDCT in a large series of patients with suspected renal colic.