Navegando por Palavras-chave "Flank pain"

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    Avaliação da concordância interobservador na análise da tomografia computadorizada sem contraste no diagnóstico da urolitíase em pacientes com cólica renal aguda
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-10-01) Souza, Luís Ronan Marquez Ferreira De [UNIFESP]; Faintuch, Salomão [UNIFESP]; Bekhor, Daniel [UNIFESP]; Tiferes, Dario Ariel [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
    OBJECTIVE: To evaluate the interobserver agreement on non-contrast computed tomography interpretation by a group of experienced abdominal radiologists, for the study of urolithiasis in patients presenting acute flank pain. MATERIALS AND METHODS: Prospective study of 52 patients submitted to non-contrast enhanced helical computed tomography. The images were subsequently analyzed by three independent observers, with the interobserver agreement assessed by means of the kappa (kappa) statistical method. The following parameters were analyzed: a) presence, localization and measurement of ureteral calculi; b) intrarenal calyceal system dilatation; c) perirenal fat heterogeneity; d) ureteral dilatation; e) ureteral wall edema (halo sign). RESULTS: Ureteral calculi were found in 40 of 52 patients (77%). The interobserver agreement was almost perfect as regards identification of ureteral calculi (kappa = 0.89) and ureteral dilatation (kappa = 0.87), substantial for calyceal system dilatation (kappa = 0.77), and moderate for perirenal fat heterogeneity (kappa = 0.55) and ureteral wall edema (kappa = 0.56). CONCLUSION: Non-contrast-enhanced abdominal computed tomography presents high reproducibility in the evaluation of urolithiasis and secondary signs of the calyceal system obstruction.
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    Comparison between ultrasound and noncontrast helical computed tomography for identification of acute ureterolithiasis in a teaching hospital setting
    (Associação Paulista de Medicina - APM, 2007-03-01) Souza, Luís Ronan Marquez Ferreira de [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Faintuch, Salomão [UNIFESP]; Faria, Juliano Ferreira [UNIFESP]; Bekhor, Daniel [UNIFESP]; Tiferes, Dario Ariel [UNIFESP]; Ortiz, Valdemar [UNIFESP]; Choyke, Peter [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: Recent studies have shown noncontrast computed tomography (NCT) to be more effective than ultrasound (US) for imaging acute ureterolithiasis. However, to our knowledge, there are few studies directly comparing these techniques in an emergency teaching hospital setting. The objectives of this study were to compare the diagnostic accuracy of US and NCT performed by senior radiology residents for diagnosing acute ureterolithiasis; and to assess interobserver agreement on tomography interpretations by residents and experienced abdominal radiologists. DESIGN AND SETTING: Prospective study of 52 consecutive patients, who underwent both US and NCT within an interval of eight hours, at Hospital São Paulo. METHODS: US scans were performed by senior residents and read by experienced radiologists. NCT scan images were read by senior residents, and subsequently by three abdominal radiologists. The interobserver variability was assessed using the kappa statistic. RESULTS: Ureteral calculi were found in 40 out of 52 patients (77%). US presented sensitivity of 22% and specificity of 100%. When collecting system dilatation was associated, US demonstrated 73% sensitivity, 82% specificity. The interobserver agreement in NCT analysis was very high with regard to identification of calculi, collecting system dilatation and stranding of perinephric fat. CONCLUSIONS: US has limited value for identifying ureteral calculi in comparison with NCT, even when collecting system dilatation is present. Residents and abdominal radiologists demonstrated excellent agreement rates for ureteral calculi, identification of collecting system dilatation and stranding of perinephric fat on NCT.