Fani Parisa, Patlas Michael N, Monteiro Sandra, Katz Douglas S
Division of Emergency/Trauma Radiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada.
Division of Emergency/Trauma Radiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada.
Curr Probl Diagn Radiol. 2019 Mar-Apr;48(2):148-151. doi: 10.1067/j.cpradiol.2018.01.009. Epub 2018 Feb 2.
To determine the yield of non-contrast multi-detector computed tomography (MDCT) of the abdomen and pelvis in diagnosing ureteral calculi as well as other alternative acute conditions in male vs in female adult patients presenting to the emergency department with new onset of symptoms.
Our institutional review board approved a retrospective review of the official reports of the non-contrast MDCT examinations of the abdomen and pelvis performed on adults (18 years and older) presenting to our emergency department with a suspected ureteral calculus from October 1, 2011 to October 30, 2013. Patients with recently documented ureteral calculi, known urinary tract infection, malignancy, and trauma were excluded from the study. From a total of 1097 non-contrast MDCT examinations of the abdomen and pelvis over the 2-year period, 400 randomly selected examinations were reviewed (approximately one-third of all the examinations). We compared the prevalence of ureteral calculi between the male and female population. P values and confidence intervals were determined using software Stata 14. Other acute intra-abdominal and intra-pelvic findings amenable to prompt medical care were also documented and analyzed separately.
The mean patient age was 55.2 years, with a range of 19-90 years. This included 170 female (mean age 56.8 years) and 230 male patients (mean age 54.2 years). Ureteral calculi were detected in 170 (42.5%) of the patients [111 males (48%) and 59 females (34.7%)] with a prevalence which was statistically significantly higher in the male patients compared to in the female patients (P < 0.01, confidence level of 95% and CI of 13.2-13.4). An alternative diagnosis was made based on the MDCT findings in 49 patient cases (12.25 %), including 26 females (15.29%) and 23 males (10.00%). There was no statistically significant difference in alternative acute findings in male compared to in female patients (P > 0.05). This was with the exception of acute pyelonephritis, which was statistically significantly higher in the female patients (P < 0.01).
The likelihood of making the diagnosis of a ureteral calculus on non-contrast MDCT of the abdomen and pelvis was statistically significantly higher in male patients compared with female patients presenting to our emergency department. However, there was no statistically significant difference in the alternative diagnoses, with the exception of pyelonephritis, which was more common in women.
确定腹部和盆腔非增强多排螺旋CT（MDCT）在诊断输尿管结石以及其他可替代的急性病症方面的检出率，这些病症出现在因新出现症状而到急诊科就诊的成年男性和女性患者中。
我们的机构审查委员会批准了一项回顾性研究，回顾了2011年10月1日至2013年10月30日期间在我们急诊科因疑似输尿管结石接受腹部和盆腔非增强MDCT检查的成年人（18岁及以上）的官方报告。近期有输尿管结石记录、已知尿路感染、恶性肿瘤和创伤的患者被排除在研究之外。在这两年期间总共1097次腹部和盆腔非增强MDCT检查中，随机抽取了400次检查进行回顾（约占所有检查的三分之一）。我们比较了男性和女性人群中输尿管结石的患病率。使用Stata 14软件确定P值和置信区间。其他适合及时医疗护理的急性腹内和盆腔内发现也分别进行记录和分析。
患者的平均年龄为55.2岁，范围为19至90岁。其中包括170名女性（平均年龄56.8岁）和230名男性患者（平均年龄54.2岁）。在170名（42.5%）患者中检测到输尿管结石[111名男性（48%）和59名女性（34.7%）]，男性患者的患病率在统计学上显著高于女性患者（P < 0.01，95%置信水平，CI为13.2 - 13.4）。根据MDCT检查结果，49例患者（12.25%）做出了替代诊断，包括26名女性（15.29%）和23名男性（10.00%）。男性患者与女性患者在替代急性发现方面没有统计学上的显著差异（P > 0.05）。急性肾盂肾炎除外，女性患者的急性肾盂肾炎在统计学上显著更高（P < 0.01）。
与到我们急诊科就诊的女性患者相比，男性患者通过腹部和盆腔非增强MDCT诊断输尿管结石的可能性在统计学上显著更高。然而，除了肾盂肾炎在女性中更常见外，替代诊断在统计学上没有显著差异。
