Current computed tomography techniques can detect duct of Bellini plugging but not Randall's plaques.

Objective: To assess the ability of noninvasive computed tomography (CT) scans to detect interstitial calcium phosphate deposits (Randall's plaques) and duct of Bellini plugs, which are possible stone precursor lesions.Methods: At time of percutaneous nephrolithotomy (PCNL) for stone removal, all ac...

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Publicado en:Urology Vol. 82; no. 2; pp. 301 - 307
Autores principales: Krambeck, Amy E, Lieske, John C, Li, Xujian, Bergstralh, Eric J, Rule, Andrew D, Holmes 3rd, David, McCollough, Cynthia M, Vrtiska, Terri J, Holmes, David 3rd
Formato: research Journal Article
Publicado: Elsevier B.V. Aug2013
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Elsevier B.V.
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        10.1016/j.urology.2013.04.028
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        atl: Current computed tomography techniques can detect duct of Bellini plugging but not Randall's plaques.
      aug:
        au:
          Krambeck, Amy E
          Lieske, John C
          Li, Xujian
          Bergstralh, Eric J
          Rule, Andrew D
          Holmes 3rd, David
          McCollough, Cynthia M
          Vrtiska, Terri J
          Holmes, David 3rd
        affil: Department of Urology, Mayo Clinic, Rochester, MN. Electronic address: krambeck.amy@mayo.edu.
      sug:
        subj:
          Kidney Calculi Radiography
          Kidney Tubules Radiography
          Tomography, X-Ray Computed
          Adult
          Aged
          Aged, 80 and Over
          Phosphates
          Female
          Human
          Image Processing, Computer Assisted
          Kidney Calculi
          Kidney Calculi Etiology
          Male
          Middle Age
          Prospective Studies
          Sensitivity and Specificity
          Single-Blind Studies
          Young Adult
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objective: To assess the ability of noninvasive computed tomography (CT) scans to detect interstitial calcium phosphate deposits (Randall's plaques) and duct of Bellini plugs, which are possible stone precursor lesions.Methods: At time of percutaneous nephrolithotomy (PCNL) for stone removal, all accessible individual papillae of 105 patients were endoscopically visualized and video recorded. Image-processing software was used to estimate the percentage of papillary surface occupied by plaque or plug in each pole (upper, middle, lower). The location of stones was also recorded. A radiologist blinded to the mapping results scored presurgical (n = 98) and postsurgical (n = 105) abdominal CT scans for the presence or absence of calcification by pole.Results: The cohort was a mean age of 56 years (range, 23-84 years). Maximum papillary surface area of each area of the kidney occupied by plug correlated with CT calcifications on pre- and postprocedure images by rank sum test. However, maximum plaque surface area did not correlate with radiographic findings (P = .10-.90 for each pole by rank sum test). Sensitivity was 81% and specificity was 69% of CT to detect plugs of at least 1% of the papillary surface area.Conclusion: Calcifications seen on current generation clinical CT scans correspond to ductal plugging involving at least 1% of the papillary surface area. Current clinical CT scan technology appears inadequate for detecting Randall's plaques.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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