Jan de Vries MD, Presenter: Nothing to Disclose

Jan De Vries, Abstract Co-Author: Nothing to Disclose

Lorentz Godfried Quekel MD, PhD, Abstract Co-Author: Nothing to Disclose

Cornelia Maria Schaefer-Prokop MD, Abstract Co-Author: Nothing to Disclose

To evaluate frequency and clinical importance of incidental extra-urogenital findings in CT examinations obtained for diagnostic workup of colic pain or hematuria.  

We retrospectively evaluated 386 consecutive CT examinations obtained between January and June 2008 for the diagnostic workup of suspected urolithiasis (186 unenhanced scans) or hematuria (200 CT urograms). Examinations for known tumors or follow-up of urolithiasis had been excluded. Extra-urogenital findings (EUFs) were categorized by clinical relevance (minor = no workup, moderate = further workup, and high = immediate workup and/or therapeutic action) and examined by type of examination, age and sex, and required additional workup.

At least one EUF was seen in 66% of patients. EUFs were significantly more frequent in patients > 45 years than in younger patients (p<0.01). 71% of patients without any EUF were younger than 45 years. EUFs with moderate clinical relevance were seen in 82/486 patients (21%); EUFs with high clinical relevance were seen in 33/486 patients (8.5%). Findings included 6 pneumonias, 4 aortic aneurysms > 5cm, 4 pulmonary malignancies, 4 liver malignancies, 1 rectum malignancy, 3 pathologic lymph adenopathies, 4 acute bowel inflammations (diverticulitis/colitis/appendicitis) and 7 others. The number of EUF did not significantly differ between males and females. EUF tended to be more frequently found after iv. contrast (high relevance, 10% versus 7%; moderate relevance, 25% versus 14%). Additional examinations for workup of EUFs were more frequently required with unenhanced CTs (n=5 versus 1, p<0.05).

Extra-urogenital findings requiring immediate further workup or elective follow up are seen in approximately one fourth of patients older than 45 years.

Because of the frequency of clinically relevant extra-urogenital findings in older patients with colic pain or hematuria a thorough search for such findings is mandatory.

de Vries, J, De Vries, J, Quekel, L, Schaefer-Prokop, C, Frequency and Importance of Incidental Extra-Urogenital Findings in CT for Workup of Colic Pain or Hematuria.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8012276.html