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ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI

Yıl 2022, Cilt: 23 Sayı: 1, 38 - 44, 17.01.2022
https://doi.org/10.18229/kocatepetip.824173

Öz

AMAÇ: Ürolitiazis her yaşı etkileyebilen sık görülen üriner bir patolojidir. Ürolitiazis için çekilen bilgisayarlı tomografi (BT) ile tüm abdominal organlar görüntülenmektedir. Renal ve ekstrarenal insidental bulguya (İB’ya) rastlanabilmektedir. Bu çalışmada ürolitiazis için abdomen BT çekilen hastalarda İB sıklığını değerlendirmeyi amaçladık.
GEREÇ VE YÖNTEM: Ocak 2019 - 2020 tarihleri arasında ürolitiazis ön tanısı ile poliklinikten yönlendirilerek abdominal BT çekilen hastalar retrospektif olarak tarandı. 1056 hasta çalışmaya dahil edildi. Bulgular renal, ekstrarenal; klinik önemli ve önemsiz bulgular olarak sınıflandırıldı. Klinik önemli bulgular 65 yaş üstü ve 65 yaş altı grupta değerlendirildi. İleri görüntüleme veya işlem gerektiren hastalar, klinik önemli hasta grubu olarak değerlendirildi.
BULGULAR: 1056 hastanın 549 (%52) tanesi erkek, 507 (%48) tanesi kadın hastaydı. Hastaların yaş ortalaması 50,55±14,95 yıldı. Altı yüz kırk beş (%61) hastada üriner sistem taşı, 675 (%63,9) hastada İB saptandı. Üç yüz iki (%28,59) hastada 304 tane insidental renal bulgu mevcuttu. Üç yüz seksen üç (%36,26) hastada ise ekstrarenal 725 bulgu saptandı. On hastada hem renal hem de ekstrarenal İB mevcuttu. Ekstrarenal İB’lar içerisinde 413 (%56,8) hastada hepatobiliyer sistemde, 136 (%18,7) hastada gastrointestinal sistemde ve 41 hastada adrenal bezde (%5,6) İB mevcuttu. 47 (%4,45) hastada klinik önemli İB saptandı. Klinik önemli İB’lar 65 yaş üstü grupta %7,23 oranında ve 65 yaş altı grupta %3,71 oranında tespit edildi.
SONUÇ: İB’lara abdomen BT’de sık rastlanır ve çoğunluğu klinik olarak önemsizdir. Yaş ile birlikte klinik önemli İB varlığında artış olmaktadır. Özellikle ileri yaş hastalarda bu bulguların asemptomatik dönemde erken tespit edilmesi ile hastaların sağ

Kaynakça

  • 1. Turney BW, Reynard JM, Noble JG, Keoghane SR. Trends in urological stone disease. BJU Int. 2012;109:1082–7.
  • 2. Preminger GM, Tiselius HG, Assimos DG, et al. 2007 guideline for the management of ureteral calculi. J Urol. 2007;178:2418–34.
  • 3. Kazi SN, Benz RL, Kazi SN, Benz RL. Work-up of hematuria. Prim Care. 2014;41:737–48.
  • 4. Flannigan R, Choy WH, Chew B, Lange D. Renal struvite stones– pathogenesis, microbiology, and management strategies. Nat Rev Urol. 2014;11:333–41.
  • 5. Wolf SM, Lawrenz FP, Nelson CA, et al. Managing incidental findings in human subjects research:analysis and recommendations. J Law Med Ethics. 2008;36:219–48.
  • 6. Orme NM, Fletcher JG, Siddiki HA, et al. Incidental findings in imaging research: evaluating incidence, benefit, and burden. Arch Intern Med. 2010;170:1525–32.
  • 7. Surov A, Bach AG, Tcherkes A, Schramm D. Non-osseous incidental findings in low-dose whole-body CT in patients with multiple myeloma. Br J Radiol. 2014;87:20140185.
  • 8. Surov A, Bach AG, Schramm D. Clinically relevant cardiovascular findings detected on staging computed tomography in patients with several malignancies. Angiology. 2016;67:630–7.
  • 9. Ather MH, Memon W, Rees J. Clinical impact of incidental diagnosis of disease on non-contrast-enhanced helical CT for acute ureteral colic. Semin Ultrasound CT MR. 2005;26:20-3.
  • 10. Shaaban MS, Kotb A. F. Value of non-naitrast CT examination of the urinary tract (stone protocol) in the detection of incidental findings and its impact upon the management. Alexandria Med J. 2016;52:209-17.
  • 11. Ahmad NA, Ather MH, ReesbJ. Incidental diagnosis of diseases on un-enhanced helical computed tomography performed for ureteric colic. BMC urology. 2003;3:2.
  • 12. Hellström M, Svensson MH, Lasson A. Extracolonic and incidental findings on CT colonography (virtual colonoscopy). AJR Am J Roentgenol 2004;182:631-8.
  • 13. Seah MK, Murphy CG, McDonald S, Carrothers A. Incidental findings on whole-body trauma computed tomography: Experience at a major trauma centre. Injury. 2016;47:691-4.
  • 14. Devine AS, Jackson CS, Lyons L,Mason JD. Frequency of incidental findings on computed tomography of trauma patients. West J Emerg Med. 2010;11:24.
  • 15. Messersmith WA, Brown DF, Barry MJ. The prevalence and implications of incidental findings on ED abdominal CT scans. Am J Emerg Med. 2001;19:479-81.
  • 16. Morgan AE, Berlan, LL, Ananyev SS, Lockhart ME, Kolettis PN. Extraurinary incidental findings on CT for hematuria: the radiologist's role and downstream cost analysis. AJR Am J Roentgenol. 2015;204:1160-7.
  • 17. Hoppe H, Studer R, Kessler TM, et al. Alternate or additional findings to stone disease on unenhanced computerized tomography for acute flank pain can impact management. J Urol. 2006;175:1725-30.
  • 18. Samim M, Goss S, Luty S, Weinreb J, Moore C. Incidental findings on CT for suspected renal colic in emergency department patients: prevalence and types in 5,383 consecutive examinations. J Am Coll Radiol. 2015;12:63-9.
  • 19. Meyer HJ, Pfeil A, Schramm D, Bach AG, Surov A. Renal incidental findings on computed tomography: Frequency and distribution in a large non selected cohort. Medicine (Baltimore). 2017;(96):e7039.
  • 20. Hoffstetter P, Herold T, Daneschnejad M, et al. Non-trauma-associated additional findings in whole-body CT examinations in patients with multiple trauma. Rofo. 2008;180:120–6.
  • 21. Badiani S, Tomas-Hernandez S, Karandikar S, Roy-Choudhury S. Extracolonic findings (ECF) on CT colonography (CTC) in patients presenting with colorectal symptoms. Acta Radiol. 2013;54:851–62.
  • 22. Lorenz EC, Vrtiska TJ, Lieske JC, et al. Prevalence of renal artery and kidney abnormalities by computed tomography among healthy adults. Clin J Am Soc Nephrol. 2010;5:431–8.
  • 23. Lindsay AC, Sriharan M, Lazoura O, et al. Clinical and economic consequences of non-cardiac incidental findings detected on cardiovascular computed tomography performed prior to transcatheter aortic valve implantation (TAVI). Int J Cardiovasc Imaging. 2015;31:1435–46.
  • 24. Bradley AJ, Lim YY, Singh FM. Imaging features, follow-up, and management of incidentally detected renal lesions. Clin Radiol. 2011;66:1129–39.
  • 25. Naidu SG, Hara AK, Brandis AR, et al. Incidence of highly important extravascular findings detected on CT angiography of the abdominal aorta and the lower extremities. AJR Am J Roentgenol 2010;194:1630–4.
  • 26. Khan N, Ather MH, Ahmed F, Zafar AM, Khan A . Has the significance of incidental findings on unenhanced computed tomography for urolithiasis been overestimated? A retrospective review of over 800 patients. Arab J. Urol. 2012;10:149-54.
  • 27. Kutaiba N, Richmond D, Morey M, et al. Incidental hepatic steatosis on unenhanced computed tomography performed for suspected renal colic: Gaps in reporting and documentation. J Med Imaging Radiat Oncol. 2019;63:431-8.
  • 28. Liu W, Mortelé KJ, Silverman SG. Incidental extraurinary findings at MDCT urography in patients with hematuria: prevalence and impact on imaging costs. AJR Am J Roentgenol. 2005;185:1051-6.

FREQUENCY OF INCIDENTAL FINDINGS IN UNENHANCED ABDOMINAL COMPUTED TOMOGRAPHY FOR DIAGNOSIS OF URINERY SYSTEM STONE

Yıl 2022, Cilt: 23 Sayı: 1, 38 - 44, 17.01.2022
https://doi.org/10.18229/kocatepetip.824173

Öz

OBJECTIVE: Urolithiasis is a common urinary tract pathology that can affect all age groups. All abdominal organs are imaged with computed tomography (CT) taken for urolithiasis. Therefore, renal and extrarenal incidental findings (IFs) may be encountered. In this study, we aimed to evaluate the incidence of IF in the patients who took abdominal CT for urolithiasis.
MATERIAL AND METHODS: Patients referred to the outpatient clinic with a pre-diagnosis of urolithiasis and who took abdominal CT between January 2019 and 2020 were evaluated retrospectively. One thousand fifty-six patients were included in the study. IFs were classified as renal - extrarenal, clinically significant - clinically insignificant findings. Clinically significant findings were evaluated in the over-65 and under-65 age groups. Patients requiring additional imaging and procedures were evaluated as a clinically significant patient group.
RESULTS: Five hundred and forty-nine (52%) of 1056 patients were male, and 507 (48%) were female. The mean age of the patients was 50.55 ± 14.95 years. Six hundred and forty-five (61%) patients had urinary stones, IF was found in 675 (63.9%) patients. Three hundred and four renal IFs were present in 302 (28.59%) patients. In 383 (36.26%) patients, 725 extrarenal findings were detected. Ten patients had both renal and extrarenal IF. In the extrarenal IFs, 413 (56.8%) patients had findings in the hepatobiliary system, 136 (18.7%) patients in the gastrointestinal system, and 41 patients (5.6%) in the adrenal gland. Clinically significant IFs were detected in 47 (4.45%) patients. Clinically significant IF was detected in 7.23% in the patient group over 65 years of age and 3.71% in the under-65 age group.
CONCLUSIONS: IFs are common in abdominal CT and most of them are clinically insignificant. The presence of clinically significant IF increases with age. It should be kept in mind that especially in elderly patients, the early detection of these findings in the asymptomatic period increases the survival and treatment chances of the patients.

Kaynakça

  • 1. Turney BW, Reynard JM, Noble JG, Keoghane SR. Trends in urological stone disease. BJU Int. 2012;109:1082–7.
  • 2. Preminger GM, Tiselius HG, Assimos DG, et al. 2007 guideline for the management of ureteral calculi. J Urol. 2007;178:2418–34.
  • 3. Kazi SN, Benz RL, Kazi SN, Benz RL. Work-up of hematuria. Prim Care. 2014;41:737–48.
  • 4. Flannigan R, Choy WH, Chew B, Lange D. Renal struvite stones– pathogenesis, microbiology, and management strategies. Nat Rev Urol. 2014;11:333–41.
  • 5. Wolf SM, Lawrenz FP, Nelson CA, et al. Managing incidental findings in human subjects research:analysis and recommendations. J Law Med Ethics. 2008;36:219–48.
  • 6. Orme NM, Fletcher JG, Siddiki HA, et al. Incidental findings in imaging research: evaluating incidence, benefit, and burden. Arch Intern Med. 2010;170:1525–32.
  • 7. Surov A, Bach AG, Tcherkes A, Schramm D. Non-osseous incidental findings in low-dose whole-body CT in patients with multiple myeloma. Br J Radiol. 2014;87:20140185.
  • 8. Surov A, Bach AG, Schramm D. Clinically relevant cardiovascular findings detected on staging computed tomography in patients with several malignancies. Angiology. 2016;67:630–7.
  • 9. Ather MH, Memon W, Rees J. Clinical impact of incidental diagnosis of disease on non-contrast-enhanced helical CT for acute ureteral colic. Semin Ultrasound CT MR. 2005;26:20-3.
  • 10. Shaaban MS, Kotb A. F. Value of non-naitrast CT examination of the urinary tract (stone protocol) in the detection of incidental findings and its impact upon the management. Alexandria Med J. 2016;52:209-17.
  • 11. Ahmad NA, Ather MH, ReesbJ. Incidental diagnosis of diseases on un-enhanced helical computed tomography performed for ureteric colic. BMC urology. 2003;3:2.
  • 12. Hellström M, Svensson MH, Lasson A. Extracolonic and incidental findings on CT colonography (virtual colonoscopy). AJR Am J Roentgenol 2004;182:631-8.
  • 13. Seah MK, Murphy CG, McDonald S, Carrothers A. Incidental findings on whole-body trauma computed tomography: Experience at a major trauma centre. Injury. 2016;47:691-4.
  • 14. Devine AS, Jackson CS, Lyons L,Mason JD. Frequency of incidental findings on computed tomography of trauma patients. West J Emerg Med. 2010;11:24.
  • 15. Messersmith WA, Brown DF, Barry MJ. The prevalence and implications of incidental findings on ED abdominal CT scans. Am J Emerg Med. 2001;19:479-81.
  • 16. Morgan AE, Berlan, LL, Ananyev SS, Lockhart ME, Kolettis PN. Extraurinary incidental findings on CT for hematuria: the radiologist's role and downstream cost analysis. AJR Am J Roentgenol. 2015;204:1160-7.
  • 17. Hoppe H, Studer R, Kessler TM, et al. Alternate or additional findings to stone disease on unenhanced computerized tomography for acute flank pain can impact management. J Urol. 2006;175:1725-30.
  • 18. Samim M, Goss S, Luty S, Weinreb J, Moore C. Incidental findings on CT for suspected renal colic in emergency department patients: prevalence and types in 5,383 consecutive examinations. J Am Coll Radiol. 2015;12:63-9.
  • 19. Meyer HJ, Pfeil A, Schramm D, Bach AG, Surov A. Renal incidental findings on computed tomography: Frequency and distribution in a large non selected cohort. Medicine (Baltimore). 2017;(96):e7039.
  • 20. Hoffstetter P, Herold T, Daneschnejad M, et al. Non-trauma-associated additional findings in whole-body CT examinations in patients with multiple trauma. Rofo. 2008;180:120–6.
  • 21. Badiani S, Tomas-Hernandez S, Karandikar S, Roy-Choudhury S. Extracolonic findings (ECF) on CT colonography (CTC) in patients presenting with colorectal symptoms. Acta Radiol. 2013;54:851–62.
  • 22. Lorenz EC, Vrtiska TJ, Lieske JC, et al. Prevalence of renal artery and kidney abnormalities by computed tomography among healthy adults. Clin J Am Soc Nephrol. 2010;5:431–8.
  • 23. Lindsay AC, Sriharan M, Lazoura O, et al. Clinical and economic consequences of non-cardiac incidental findings detected on cardiovascular computed tomography performed prior to transcatheter aortic valve implantation (TAVI). Int J Cardiovasc Imaging. 2015;31:1435–46.
  • 24. Bradley AJ, Lim YY, Singh FM. Imaging features, follow-up, and management of incidentally detected renal lesions. Clin Radiol. 2011;66:1129–39.
  • 25. Naidu SG, Hara AK, Brandis AR, et al. Incidence of highly important extravascular findings detected on CT angiography of the abdominal aorta and the lower extremities. AJR Am J Roentgenol 2010;194:1630–4.
  • 26. Khan N, Ather MH, Ahmed F, Zafar AM, Khan A . Has the significance of incidental findings on unenhanced computed tomography for urolithiasis been overestimated? A retrospective review of over 800 patients. Arab J. Urol. 2012;10:149-54.
  • 27. Kutaiba N, Richmond D, Morey M, et al. Incidental hepatic steatosis on unenhanced computed tomography performed for suspected renal colic: Gaps in reporting and documentation. J Med Imaging Radiat Oncol. 2019;63:431-8.
  • 28. Liu W, Mortelé KJ, Silverman SG. Incidental extraurinary findings at MDCT urography in patients with hematuria: prevalence and impact on imaging costs. AJR Am J Roentgenol. 2005;185:1051-6.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Emre Emekli 0000-0001-5989-1897

Elif Gündoğdu 0000-0002-1729-6958

Yayımlanma Tarihi 17 Ocak 2022
Kabul Tarihi 6 Nisan 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 23 Sayı: 1

Kaynak Göster

APA Emekli, E., & Gündoğdu, E. (2022). ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI. Kocatepe Tıp Dergisi, 23(1), 38-44. https://doi.org/10.18229/kocatepetip.824173
AMA Emekli E, Gündoğdu E. ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI. KTD. Ocak 2022;23(1):38-44. doi:10.18229/kocatepetip.824173
Chicago Emekli, Emre, ve Elif Gündoğdu. “ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI”. Kocatepe Tıp Dergisi 23, sy. 1 (Ocak 2022): 38-44. https://doi.org/10.18229/kocatepetip.824173.
EndNote Emekli E, Gündoğdu E (01 Ocak 2022) ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI. Kocatepe Tıp Dergisi 23 1 38–44.
IEEE E. Emekli ve E. Gündoğdu, “ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI”, KTD, c. 23, sy. 1, ss. 38–44, 2022, doi: 10.18229/kocatepetip.824173.
ISNAD Emekli, Emre - Gündoğdu, Elif. “ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI”. Kocatepe Tıp Dergisi 23/1 (Ocak 2022), 38-44. https://doi.org/10.18229/kocatepetip.824173.
JAMA Emekli E, Gündoğdu E. ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI. KTD. 2022;23:38–44.
MLA Emekli, Emre ve Elif Gündoğdu. “ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI”. Kocatepe Tıp Dergisi, c. 23, sy. 1, 2022, ss. 38-44, doi:10.18229/kocatepetip.824173.
Vancouver Emekli E, Gündoğdu E. ÜRİNER SİSTEM TAŞI TANISI İÇİN ÇEKİLEN KONTRASTSIZ ABDOMEN BİLGİSAYARLI TOMOGRAFİLERDEKİ İNSİDENTAL BULGU SIKLIĞI. KTD. 2022;23(1):38-44.

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