Browsing by Subject "computerized tomography"

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    Computerized Tomography of the Acute Left Upper Quadrant Pain
    (Springer, 2016-08) Tirkes, Temel; Ballenger, Zachary; Steenburg, Scott D.; Altman, Daniel J.; Sandrasegaran, Kumaresan; Department of Radiology and Imaging Sciences, IU School of Medicine
    The purpose of this study was to evaluate the clinical utility of computerized tomography (CT) of the abdomen in the emergent setting of left upper quadrant pain. One hundred patients (average age: 45, range: 19–93 years, female: 57 %, male: 43 %) who presented to the emergency department (ED) and underwent CT scanning of abdomen with the given indication of left upper quadrant pain were included in this study. The results from CT examinations were compared to final diagnoses determined by either ED physician or clinician on a follow-up visit. Sensitivity of CT was 69 % (95 %CI: 52–83 %) for 39 patients who eventually were diagnosed with an acute abdominal abnormality. Twenty-seven patients had an acute abnormal finding on abdominal CT that represented the cause of the patient’s pain (positive predictive value of 100 %, 95 %CI: 87–100 %). Of the remaining 73 patients with negative CT report, 12 were diagnosed clinically (either in the ED or on follow-up visit to specialist) with a pathology that was undetectable on the CT imaging (negative predictive value of 83 %, 95 %CI: 73–91 %). None of the remaining 61 patients with negative CT were found to have pathology by clinical evaluation (specificity of 100 %, 95 %CI: 94–100 %). CT is a useful examination for patients with acute left upper quadrant pain in the emergency department setting with moderate sensitivity and excellent specificity.
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    Sensitivity of Non-Contrast Computed Tomography for Small Renal Calculi with Endoscopy as the Gold Standard
    (Elsevier, 2018) Bhojani, Naeem; Paonessa, Jessica E.; El Tayeb, Marawan M.; Williams, James C.; Hameed, Tariq A.; Lingeman, James E.; Urology, School of Medicine
    Objectives To compare the sensitivity of non-contrast CT to endoscopy for detection of renal calculi. Imaging modalities for detection of nephrolithiasis have centered on abdominal x-ray (KUB), ultrasound (US), and non-contrast computed tomography (CT). Sensitivities of 58-62% (KUB), 45% (US), and 95-100% (CT) have been previously reported. However, these results have never been correlated with endoscopic findings. Methods Idiopathic calcium oxalate stone formers with symptomatic calculi requiring ureteroscopy (URS) were studied. At the time of surgery, the number and location of all calculi within the kidney were recorded followed by basket retrieval. Each calculus was measured and sent for micro CT and infrared spectrophotometry. All CT scans were reviewed by the same genitourinary radiologist who was blinded to the endoscopic findings. The radiologist reported on the number, location, and size of each calculus. Results 18 renal units were studied in 11 patients. Average time from CT scan to URS was 28.6 days. The mean number of calculi identified per kidney was 9.2±6.1 for endoscopy and 5.9±4.1 for CT (p<0.004). The mean size of total renal calculi (sum of longest stone diameters) per kidney was 22.4±17.1 mm and 18.2±13.2 mm for endoscopy and CT, respectively (p=0.06). Conclusions CT scan underreports the number of renal calculi, probably missing some small stones and unable to distinguish those lying in close proximity to one another. However, the total stone burden seen by CT is, on average, accurate when compared to that found on endoscopic examination.