Imaging Modalities - Essay Example

Imaging has an essential role in diagnosis, management and follows up of the patient suffering from stone diseases. There are different types of imaging modalities which are available to the practicing urologist (Brisbane et al., 2016). These include conventional radiography (KUB), ultrasound (US), intravenous urography (IVU), magnetic resonance urography (MRU) and finally the computed tomography(CT). Each has a list of its advantages and limitations as well but currently as seen CT scan is considered the best due to basically its high sensitivity along with specificity and the ease of performing the study by CT. It records sensitivity and specificity of 81% and 100% respectively for ureteric stones on a patient (Ibrahim et al., 2016). As compared to other imaging modalities found in the medical field such as US it has the lowest score of 46% in the diagnosis of ureteric stones. While for the KUB diagnosis it records 77% of the ureteric stones.

In other comparisons, IVU comes short when differentiating between acute obstruction from residual changes due to previous obstruction (Renard-Penna et al., 2015). CT stands out again since it can be capable of determining parenchymal attenuation which can be used in the differentiation of chronic and acute obstruction. KUB and IVU are mostly used in the follow up of the patient treated of urolithiasis since they help determine the outcome although being they are not very sensitive and can lead to underestimation of the residual fragment rates within the patient (Sternberg & Littenberg, 2017). CT happens to have the ability to improve the detection of residual fragments present with higher radiation exposure hence the is more accurate while KUB and US are overestimated when they are used for follow up.

When using MRU, the stones are not directly visible since they produce no signal. But can be indirectly detected as a filling in the ureter (Tasian et al., 2014). But unlike MRU the Ultrasonography the stones are detected and seen as bright echogenic foci with posterior acoustic shadowing hence the direct visibility makes way better than MRU. For the CT findings, the following are detected; stones in the ureter as seen earlier, hydronephrosis (83% sensitivity and 94% specific) Perinephric fluid (82% sensitive, 93% specific), Ureteral dilatation (90% sensitive, 93% specific) and enlarged kidney (Xie et al., 2017). This makes CT the be imaging modality among all the others present.

References

Brisbane, W., Bailey, M. R., & Sorensen, M. D. (2016). An overview of kidney stone imaging techniques. Nature reviews. Urology, 13(11), 654.

Ibrahim, E. S. H., Cernigliaro, J. G., Bridges, M. D., Pooley, R. A., & Haley, W. E. (2016). The Capabilities and Limitations of Clinical Magnetic Resonance Imaging for Detecting Kidney Stones: A Retrospective Study. International journal of biomedical imaging, 2016.

Renard-Penna, R., Martin, A., Conort, P., Mozer, P., & Grenier, P. (2015). Kidney stones and imaging: What can your radiologist do for you?. World journal of urology, 33(2), 193-202.

Sternberg, K. M., & Littenberg, B. (2017). Trends in imaging use for the evaluation andfollowup of kidney stone disease: a single center experience. The Journal of Urology.

Tasian, G. E., Pulido, J. E., Keren, R., Dick, A. W., Setodji, C. M., Hanley, J. M., ... & Saigal, C. S. (2014). Use of and regional variation in initial CT imaging for kidneystones. Pediatrics, 134(5), 909-915.

Xie, D., Nehrenz, G. M., Bianco, F., Klopukh, B., & Gheiler, E. (2017). Magnetic Resonance Urography as an Imaging Modality for Urinary Stone Diseases. Journal of Clinical Nephrology and Renal Care, 3(1).