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• W2159419421 abstract "No AccessJournal of UrologySection on Urology American Academy of Pediatrics1 Oct 2009Ultrasound Versus Computerized Tomography for Evaluating Urolithiasis Carlo Passerotti, Jeanne S. Chow, Andres Silva, Cynthia L. Schoettler, Ilina Rosoklija, Jeannette Perez-Rossello, Marc Cendron, Bartley G. Cilento, Richard S. Lee, Caleb P. Nelson, Carlos R. Estrada, Stuart B. Bauer, Joseph G. Borer, David A. Diamond, Alan B. Retik, and Hiep T. Nguyen Carlo PasserottiCarlo Passerotti More articles by this author , Jeanne S. ChowJeanne S. Chow More articles by this author , Andres SilvaAndres Silva More articles by this author , Cynthia L. SchoettlerCynthia L. Schoettler More articles by this author , Ilina RosoklijaIlina Rosoklija More articles by this author , Jeannette Perez-RosselloJeannette Perez-Rossello More articles by this author , Marc CendronMarc Cendron More articles by this author , Bartley G. CilentoBartley G. Cilento More articles by this author , Richard S. LeeRichard S. Lee More articles by this author , Caleb P. NelsonCaleb P. Nelson More articles by this author , Carlos R. EstradaCarlos R. Estrada More articles by this author , Stuart B. BauerStuart B. Bauer More articles by this author , Joseph G. BorerJoseph G. Borer More articles by this author , David A. DiamondDavid A. Diamond More articles by this author , Alan B. RetikAlan B. Retik More articles by this author , and Hiep T. NguyenHiep T. Nguyen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.03.072AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We prospectively evaluated the precision of ultrasound and computerized tomography to diagnose urinary stones in children and determined whether these differences in radiological findings have any impact on clinical management. Materials and Methods: A total of 50 consecutive patients with suspected urolithiasis underwent computerized tomography and ultrasound. Two radiologists reviewed each study independently in blinded fashion. When a difference in findings was detected, 8 pediatric urologists reviewed the case. Clinical management was based on the results of each radiological test independently. Statistical analysis was performed using Fisher's exact test. Results: Compared to computerized tomography ultrasound had 76% sensitivity and 100% specificity. In 8 patients stone(s) seen on computerized tomography was not seen on ultrasound. The average size of missed stones was 2.3 mm. In 7 patients computerized tomography showed stones bilaterally but stone was seen on only 1 side on ultrasound. When evaluating the clinical impact, the ultrasound/computerized tomography discrepancy did not result in any significant change in clinical management except in 4 cases. In these cases ultrasound findings suggested that additional imaging was required and, thus, stone(s) in the distal ureter would have been identified on subsequent imaging. Conclusions: Although computerized tomography is more sensitive for detecting urolithiasis than ultrasound, the difference in usefulness between the 2 radiological tests may not be clinically significant. Given concerns for the potentially harmful cumulative long-term effect of radiation, ultrasound should be considered the first imaging test in children with suspected urolithiasis. References 1 : Urolithiasis. In: Pediatric Surgery and Urology: Long Term Outcomes. Edited by . Cambridge, United Kingdom: Cambridge University Press2006: 695. Google Scholar 2 : Low dose unenhanced helical computerized tomography for the evaluation of acute flank pain. J Urol2002; 167: 1687. 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Google Scholar Departments of Urology and Radiology (JSC, JPR), Children's Hospital Boston, Boston, Massachusetts© 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byZiemba J, Canning D, Lavelle J, Kalmus A and Tasian G (2014) Patient and Institutional Characteristics Associated with Initial Computerized Tomography in Children Presenting to the Emergency Department with Kidney StonesJournal of Urology, VOL. 193, NO. 5S, (1848-1854), Online publication date: 1-May-2015.Chen T, Wang C, Ferrandino M, Scales C, Yoshizumi T, Preminger G and Lipkin M (2018) Radiation Exposure during the Evaluation and Management of NephrolithiasisJournal of Urology, VOL. 194, NO. 4, (878-885), Online publication date: 1-Oct-2015.Johnson E, Graham D, Chow J and Nelson C (2018) Nationwide Emergency Department Imaging Practices for Pediatric Urolithiasis: Room for ImprovementJournal of Urology, VOL. 192, NO. 1, (200-206), Online publication date: 1-Jul-2014.Tasian G, Cost N, Granberg C, Pulido J, Rivera M, Schwen Z, Schulte M and Fox J (2018) Tamsulosin and Spontaneous Passage of Ureteral Stones in Children: A Multi-Institutional Cohort StudyJournal of Urology, VOL. 192, NO. 2, (506-511), Online publication date: 1-Aug-2014.Tasian G and Copelovitch L (2018) Evaluation and Medical Management of Kidney Stones in ChildrenJournal of Urology, VOL. 192, NO. 5, (1329-1336), Online publication date: 1-Nov-2014.Fulgham P, Assimos D, Pearle M and Preminger G (2018) Clinical Effectiveness Protocols for Imaging in the Management of Ureteral Calculous Disease: AUA Technology AssessmentJournal of Urology, VOL. 189, NO. 4, (1203-1213), Online publication date: 1-Apr-2013.Routh J, Graham D and Nelson C (2010) Trends in Imaging and Surgical Management of Pediatric Urolithiasis at American Pediatric HospitalsJournal of Urology, VOL. 184, NO. 4S, (1816-1822), Online publication date: 1-Oct-2010. Volume 182Issue 4SOctober 2009Page: 1829-1834 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordssensitivity and specificityurinary calculiultrasonographyx-ray computedtomographyAcknowledgmentsDr. George Taylor provided invaluable support and advice, and Nancy Drinan assisted with manuscript preparation.MetricsAuthor Information Carlo Passerotti More articles by this author Jeanne S. Chow More articles by this author Andres Silva More articles by this author Cynthia L. Schoettler More articles by this author Ilina Rosoklija More articles by this author Jeannette Perez-Rossello More articles by this author Marc Cendron More articles by this author Bartley G. Cilento More articles by this author Richard S. Lee More articles by this author Caleb P. Nelson More articles by this author Carlos R. Estrada More articles by this author Stuart B. Bauer More articles by this author Joseph G. Borer More articles by this author David A. Diamond More articles by this author Alan B. Retik More articles by this author Hiep T. Nguyen More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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