Advances in chronic kidney disease
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Adv Chronic Kidney Dis · Jan 2009
ReviewImaging in diagnosis, treatment, and follow-up of stone patients.
Imaging has an essential role in the diagnosis, management, and follow-up of patients with stone disease. A variety of imaging modalities are available to the practicing urologist, including conventional radiography (KUB), intravenous urography (IVU), ultrasound (US), magnetic resonance urography, and computed tomography (CT) scans, each with its advantages and limitations. Traditionally, IVU was considered the gold standard for diagnosing renal calculi, but this modality has largely been replaced by unenhanced spiral CT scans at most centers. ⋯ Patients with asymptomatic calyceal stones who prefer an observational approach should have a yearly KUB to monitor progression of stone burden. Current research has been aimed toward the development of a micro-CT scan and coherent-scatter analysis to determine stone composition in vivo. This may have a significant impact on the future clinical management of renal calculi by facilitating selection of the most appropriate surgical intervention based on stone composition at the time of presentation.
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Adv Chronic Kidney Dis · Jan 2009
ReviewRadiology of urolithiasis: implications of radiation exposure and new imaging modalities.
Computed tomography (CT) scanning is now the standard imaging technique for detecting and characterizing urolithiasis. However, the potential effects of the radiation exposure from CT examinations have raised concern among some physicians. This article describes the radiation doses for various urolithiasis-imaging techniques and describes techniques to optimize and reduce radiation exposures to patients undergoing these examinations. Potential future directions in radiologic techniques used for studying urolithiasis are also discussed.