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Organo Oficial de la Sociedad Mexicana de Urología

2020, Number 2

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Rev Mex Urol 2020; 80 (2)

Variation in the radiologic and urologic interpretation of computed tomography in relation to upper urinary tract stones, at a national referral hospital

Calvo-Vázquez I, Rodríguez-Rodríguez B, Hernández-Méndez EA, Bravo-López GP, Sánchez-Aquino UC, Véliz-Cabrera GA, Martínez-Arroyo C, Fernández-Noyola G, Morales-Montor JG, Cantellano-Orozco M, Pacheco-Gahbler C

Language: Spanish
References: 14
Page: 1-8
PDF size: 215.20 Kb.


ABSTRACT

Objective: To compare the discrepancy in computed tomography (CT) interpretations between urologists and radiologists in relation to uroli-thiasis and determine whether it can affect treatment.
Materials and methods: All the patients with a radiologic report of urolithia-sis were analyzed, utilizing the Cohen’s kappa statistic and the Mann-Whit-ney U test, within the time frame of November 2017 to May 2018.
Results: A total of 142 patients, made up of 56.3% men and 43.7% wo-men, with a mean age of 46 years, were included in the study. The main indication for CT was pain (74.6%), the most frequently ordered CT was a non-contrast scan (82.4%), and 36.6% of the studies were bilate-ral. Stone size, HU, and ectasia grade were not present in the radiologic reports at 8.6%, 17.3%, and 12.3%, respectively. Overall concordance for stone size was 20% when there was more than one stone, and 55% when there was a single stone (p≤0.001). Concordance was 77% when stone size was classified according to the AUA (p≤0.001).
Conclusions: There was considerable variation between the two spe-cialties, emphasizing the need to utilize morphometry as a standardi-zed method, thus obtaining a better, more accurate interpretation. It is important for the urologist to view the CT scan before deciding upon management. An estimated 31% of urologists rely solely on the report of the radiologist.


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