title: Computed tomography urography for diagnosis of calyceal diverticulum complicated by urolithiasis: the accuracy and the effect of abdominal compression and prolongation of acquisition delay.
abstract: OBJECTIVE
  To evaluate the accuracy of computed tomography urography (CTU) in the detection of caliceal diverticulum (CD) complicated with urolithiasis and the effect of compression and prolongation of acquisition delay.
  
  
  METHODS
  All data were collected from a previous research between 2002 and 2011 at 3 hospitals. A total of 182 patients with evidence of renal parenchymal cystic lesion with calcific density were evaluated by CTU. Excretory phase imaging was acquired at 10 minutes and 60 minutes for each patient. Eighty-three patients received abdominal compression intervention during 10-minutes delay.
  
  
  RESULTS
  CDs with stones were finally diagnosed in 41 patients (22.5%). Opacification within an apparent cyst was found in 31 patients (75.6%) when excretory phase images were acquired at 10 minutes and 38 patients (92.7%) at 60 minutes. The sensitivity and accuracy were significantly better with 60-minutes delay than with 10-minutes delay (92.7% vs 75.6%, P = .016 and 97.8% vs 94.0%, P = .016, respectively). The diagnostic results of compression group had significantly higher sensitivity and accuracy than that of the noncompression group (94.4% vs 60.9%, P = .025 and 98.8% vs 90.9%, P = .023, respectively).
  
  
  CONCLUSIONS
  It is important to distinguish CD from other diseases such as complex cyst when diagnosing a renal parenchymal cystic lesion with wall calcification. CTU has high sensitivity and accuracy in the detection of CD. Abdominal compression and longer imaging delay can significantly improve the diagnostic effect of CTU.
authors.affiliation: Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, China; Department of Urology, Lihuili Hospital, Ningbo Medical Center, China.
authors.forename: Ningshu
authors.initials: N
authors.lastname: Lin
authors.forename: Liping
authors.initials: L
authors.lastname: Xie
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.forename: Yin
authors.initials: Y
authors.lastname: Min
authors.forename: Yuanqing
authors.initials: Y
authors.lastname: Yang
authors.forename: Yongtao
authors.initials: Y
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Xia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004240:Diverticulum / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007670:Kidney Calices; D007674:Kidney Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014567:Urography / Q000379:methods; D052878:Urolithiasis / Q000209:etiology*; D055815:Young Adult