Khan Nadir, Ather M Hammad, Ahmed Farhan, Zafar Abdul M, Khan Aamir
Department of Radiology, Aga Khan University, Karachi, Pakistan.
Department of Surgery, Aga Khan University, Karachi, Pakistan.
Arab J Urol. 2012 Jun;10(2):149-54. doi: 10.1016/j.aju.2012.01.002. Epub 2012 Feb 20.
To evaluate the detection of clinically unsuspected pathologies using 64-slice multidetector computed tomography (CT) of the abdomen in patients with flank pain. The presence of significant incidental findings (those warranting immediate management) was also correlated with that of urolithiasis, to assess potential changes of management.
The study included 899 patients undergoing CT in a 6-month period between June and December 2008. Patients who were referred from outside, with no medical record in the hospital where the study was conducted, and those who were lost to follow-up, were excluded. All of the CT examinations were reported after a radiology resident and a consultant radiologist with >4 years of experience evaluated the CT. Genitourinary and extra-genitourinary findings were assessed and divided into clinically significant or not.
The overall incidence of additional and incidental findings was 14%. Besides urolithiasis and obstruction there were 34 (28%) genitourinary findings and 87 (72%) extra-genitourinary findings; most of the former were insignificant. Of the extra-genitourinary findings, significant diagnoses were documented in 34 cases.
Abdominal multidetector CT detects more incidental findings which are clinically significant.
评估使用64层螺旋CT对胁腹痛患者进行腹部检查时，对临床未怀疑的病变的检测情况。还将显著偶然发现（那些需要立即处理的发现）的存在情况与尿路结石的存在情况进行关联，以评估处理方式的潜在变化。
本研究纳入了2008年6月至12月期间6个月内接受CT检查的899例患者。排除了从外部转诊、在进行研究的医院无病历记录以及失访的患者。所有CT检查均在放射科住院医师和一名经验超过4年的放射科顾问医师评估CT后进行报告。对泌尿生殖系统和泌尿生殖系统外的发现进行评估，并分为具有临床意义或无临床意义。
额外和偶然发现的总体发生率为14%。除尿路结石和梗阻外，有34项（28%）泌尿生殖系统发现和87项（72%）泌尿生殖系统外发现；前者大多数无临床意义。在泌尿生殖系统外发现中，34例有显著诊断。
腹部多层螺旋CT能检测出更多具有临床意义的偶然发现。
