Radiological signs of stone impaction add no value in predicting spontaneous stone passage.
Impaction
Passage
Prediction
Ureteral stone
Journal
Urolithiasis
ISSN: 2194-7236
Titre abrégé: Urolithiasis
Pays: Germany
ID NLM: 101602699
Informations de publication
Date de publication:
06 Aug 2024
06 Aug 2024
Historique:
received:
06
05
2024
accepted:
07
07
2024
medline:
6
8
2024
pubmed:
6
8
2024
entrez:
6
8
2024
Statut:
epublish
Résumé
Stone size and location are key factors in predicting spontaneous stone passage (SSP), but little attention has been paid to the influence of radiological signs of stone impaction (RSSI). This research aims to determine whether RSSI, alongside stone size, can predict SSP and to evaluate the consistency of ureteral wall thickness (UWT) measurements among observers. In this retrospective study, 160 patients with a single upper or middle ureteral stone on acute non-enhanced computed tomography (NCCT) were analysed. Patient data were collected from medical records. Measurements of RSSI, including UWT, ureteral diameters, and average attenuation above and below the stone, were taken on NCCT by four independent readers blind to the outcomes. The cohort consisted of 70% males with an average age of 51 ± 15. SSP occurred in 61% of patients over 20 weeks. The median stone length was 5.7 mm (IQR: 4.5-7.3) and was significantly shorter in patients who passed their stones at short- (4.6 vs. 7.1, p < 0.001) and long-term (4.8 vs. 7.1, p < 0.001) follow-up. For stone length, the area under the receiver operating characteristic curve (AUC) for predicting SSP was 0.90 (CI 0.84-0.96) and only increased to 0.91 (CI 0.85-0.95) when adding ureteral diameters and UWT. Ureteral attenuation did not predict SSP (AUC < 0.5). Interobserver variability for UWT was moderate, with ± 2.0 mm multi-reader limits of agreement (LOA). The results suggest that RSSI do not enhance the predictive value of stone size for SSP. UWT measurements exhibit moderate reliability with significant interobserver variability.
Identifiants
pubmed: 39105826
doi: 10.1007/s00240-024-01604-0
pii: 10.1007/s00240-024-01604-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
114Subventions
Organisme : Region Örebro län
ID : OLL-935231
Informations de copyright
© 2024. The Author(s).
Références
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