Literature DB >> 31541403

A novel use of attenuation value (Hounsfield unit) in non-contrast CT: diagnosis of pyonephrosis in obstructed systems.

Ismail Basmaci1, Ertugrul Sefik2.   

Abstract

PURPOSE: To evaluate the predictive value of attenuation value (HU) in renal pelvis urine for detecting renal pelvis urine culture (RPUC) positivity in obstructed urinary systems.
METHODS: The study group consisted of patients who had nephrostomy insertion performed because of obstructed system and suspicion of pyonephrosis and percutaneous nephrolithotomy (PCNL) patients who had obstructed calculi. Group 1 consisted of RPUC positive 28 patients during nephrostomy insertion or needle access in PCNL and group 2 consisted of 23 patients with negative RPUC. RPUC results and non-contrast computed tomography measurements [Hounsfield unit (HU)] were compared between group 1 and group 2. A cut-off value was determined for HU. All patients were grouped according to whether they were above or below this value.
RESULTS: The median HU calculated from the renal pelvis was - 8.5 (range - 29/- 1) and 10 (range- 4/+ 17) (p < 0.001) in group 1 and group 2, respectively. The cut-off value of HU that predicted positive RPUC was 0. Sensitivity and specificity of HU when considering this cut-off value were 100% and 96%, respectively (p < 0.001). Whereas RPUC positivity was found in 96.6% (28/29) of patients with HU < 0, there were no patients with HU > 0 where RPUC positivity was detected (p < 0.001).
CONCLUSION: In this cohort, we found that HU of the urine in the renal pelvis can be used to predict RPUC positivity.

Entities:  

Keywords:  Attenuation value (Hounsfield unit); Computed tomography; Pyonephrosis; Urinary tract obstruction; Urine culture

Mesh:

Year:  2019        PMID: 31541403     DOI: 10.1007/s11255-019-02283-2

Source DB:  PubMed          Journal:  Int Urol Nephrol        ISSN: 0301-1623            Impact factor:   2.370


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