[Sensitivity of abdominal radiography without preparation compared with computed tomography in the assessment of residual fragments after percutaneous nephrolithotomy].
BACKGROUND
Evaluation of possible residual fragments after percutaneous nephrolithotomy is an essential aspect of the management of stone disease. The results of this evaluation determine the therapeutic approach, follow-up and presumed duration of treatment. The imaging modalities most frequently used are non-enhanced spiral computed tomography and plain abdominal x-ray. The objective of this study was to evaluate the contribution of spiral CT to the immediate follow-up of percutaneous nephrolithotomy.


METHODS
Over a period of two years, we prospectively included 50 patients in whom plain abdominal x-ray and spiral CT were performed on the first postoperative day after percutaneous nephrolithotomy. The diagnosis of residual fragments was based on these examinations by 2 independent radiologists.


RESULTS
The sensitivity for the detection of residual fragments was 87% for plain abdominal x-ray compared 100% for computed tomography. 89% of the fragments not diagnosed by plain abdominal x-ray were less than 5 min.


CONCLUSIONS
Plain abdominal x-ray was insufficient for the diagnosis of small residual fragments. Spiral CT is justified to confirm the absence of residual fragments in a patient after percutaneous nephrolithotomy despite the higher cost and irradiation compared to plain abdominal x-ray.
Pires
Christophe
C
Service d'Urologie, CHU La Milétrie, 86021 Poitiers. c.pires@chu-poitiers.fr
Machet
Frédéric
F
Dahmani
Laurent
L
Irani
Jacques
J
Dore
Bertrand
B
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging* / Q000601:surgery*; D007670:Kidney Calices; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D011446:Prospective Studies; D011860:Radiography, Abdominal; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed