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Nephron Clin Pract. 2007;106(3):c119-24. Epub 2007 May 22.

A critical appraisal of the radiological evaluation of nephrocalcinosis.

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  • 1Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.

Abstract

BACKGROUND/AIM:

The level of agreement concerning the diagnosis of nephrocalcinosis (NC) based on ultrasonography (US), computed tomography (CT) or kidney/ureter/bladder (KUB) X-ray was assessed.

METHODS:

Sequences of KUB+US+CT from 62 patients, 48 with at least one exam suggesting NC and 14 with pelvicalyceal calcifications (nephrolithiasis) were reviewed twice by 3 radiologists (firstly randomized and secondly presenting KUB+US+CT of each patient together).

RESULTS:

The intraobserver concordance varied from 76 to 90% for KUB, 77 to 85% for US and 82 to 89% for CT. There was a significant change in diagnosis between the 1st and 2nd reviews for observer 1 in KUB and CT, for observer 2 in US, but not for observer 3. Evaluating patients' exams together did not provide a better agreement. The highest sensitivity and specificity (92 and 89%, respectively) were only attained when 2 exams suggested NC diagnosis, being CT one of them. These enabled us to suggest that 33 out of 48 (62.5%) patients had NC (evidenced in US+CT+KUB (81.8%), US+CT (12.1%) or KUB+CT (6.1%).

CONCLUSION:

The low level of concordance renders the radiological diagnosis of NC difficult. Nephrocalcinosis should be confirmed by CT combined with either US or KUB.

Copyright 2007 S. Karger AG, Basel.

PMID:
17522474
[PubMed - indexed for MEDLINE]
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