Veysel KAPLANOĞLU, Hatice KAPLANOĞLU, Levent ALTIN, İzzet Selçuk PARLAK, Aysun E. OKAY, Günay RONA

Böğür Ağrılı Hastalarda Kontrastsız Multidedektör Bilgisayarlı Tomografide Saptanan Alternatif ve İnsidental Bulgular: Prevalans ve Karakteristikler

Amaç: Kontrastsız bilgisayarlı tomografi yüksek sensitivite(%96-100) ve spesivitesi(% 92-100) nedeniyle üriner sistem taşlarını saptamada son yıllarda standart bir teknik haline gelmiştir. Ürolitiazis nedeniyle araştırılan hastaların hemen hemen yarısında taş saptanamazken 1/3’ünde alternatif bir ağrı nedeni bulunmaktadır. Bu çalışmada üriner sistem taş hastalığına yönelik yapılan kontrastsız multidedektör bilgisayarlı tomografi incelemesinde saptadığımız alternatif ağrı nedenleri ile insidental bulguların sıklığını ve karakteristiklerini sunmaktayız. Gereç ve Yöntem: Ürolitiazis şüphesiyle 719 hastaya kliniğimizde 64 kesitli bilgisayarlı tomografi ile kontrastsız inceleme yapıldı. İncelemeler retrospektif olarak değerlendirildi. Üriner sistem ve üriner sistem dışı alternatif ve insidental bulgular kaydedildi. Bulgular: Toplam 56 majör, 162 ılımlı ve 320 minör bulgu saptandı. En sık saptanan bulgu 70(% 9,7) hastada saptadığımız renal kortikal kist olup bunu 32(% 4,5) hastayla kolelitiyazis takip etmekteydi. Majör bulguların büyük bölümünü maligniteler oluşturmaktaydı. 6 disk hernisi (%0,8), 12 spondilolistezis (%1,7), 8 kompresyon fraktürü (%1,1) vertebral sisteme ait önemli bulgulardı. Sonuç: Saptadığımız majör insidental ve alternatif bulgular literatürdekilerle benzerdir. Literatürdeki benzer çalışmalarda, bizim saptadığımız vertebral sistemi ilgilendiren insidental bulgulara pek rastlanmamıştır. Koronal ve sagittal reformat görüntülerin bu bulguların saptanmasında katkısı olduğunu düşünmekteyiz. Kontrastsız multidedektör BT’de üriner sistem taş hastalığının tipik bulgularını ve alternatif bulguların spektrumunu bilmek hastaların doğru tanı ve tedavisinde oldukça önemlidir.

Alternative and Incidental Findings on Unhanced MDCT in Patients with Flank Pain: Prevalence and the Characteristics

Objectıve: Unenhanced computed tomography is a rapid, high sensitivie technique for urinary stone determina- tion. In this study, we present alternative causes of flank pain and frequency and charasteritics of incidental findingsdetected on MDCT.Material And Method: Unenhanced CT scans of 719 patients abdomen were obtained with 64-MDCT for sus- pected urolithiasis. The images were analysed retrospectively. Urinary stones and their effects to urinary organswere evaluated, but also alternative and incidental findings were noted.Results: We detected 56 major, 162 moderate and 320 minor findings. The most common findings were renal corti- cal cysts in 70 (9,7%) patients. A large part of major findings were malignancies. We determined 6(0,8%) lomberdisc hernia, 12(1,7%) spondilolisthesis, 8(1,1%) compression fracture with the help of sagittal and coronal refor- matted images.Conclusıon: Our major findings rate was similar to literature. There were not much vertebral findings in similarstudies. We suggest that coronal and sagittal reformatted images contribute to detect these skeletal findings. Although stone disease is the most common cause of flank pain, we have to be aware of alternative diseases that can create similar flank pain and incidental findings that may need rapid treatment.

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