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Titolo:
IVU, an examination of the past without a future?
Autore:
Laissy, JP; Abecidan, E; Karila-Cohen, P; Ravery, V; Schouman-Claeys, E;
Indirizzi:
Hop Bichat, Serv Radiol, F-75018 Paris, France Hop Bichat Paris France F-75018 chat, Serv Radiol, F-75018 Paris, France Hop Bichat, Serv Urol, F-75018 Paris, France Hop Bichat Paris France F-75018 Bichat, Serv Urol, F-75018 Paris, France
Titolo Testata:
PROGRES EN UROLOGIE
fascicolo: 3, volume: 11, anno: 2001,
pagine: 552 - 561
SICI:
1166-7087(200106)11:3<552:IAEOTP>2.0.ZU;2-S
Fonte:
ISI
Lingua:
FRE
Soggetto:
RENAL-ARTERY STENOSIS; SPIRAL COMPUTERIZED-TOMOGRAPHY; MAGNETIC-RESONANCE ANGIOGRAPHY; NONENHANCED HELICAL CT; ACUTE FLANK PAIN; MR UROGRAPHY; EXCRETORY UROGRAPHY; URETERAL CALCULI; URINARY-TRACT; DIAGNOSIS;
Keywords:
CT scan; IVU; kidney stones; kidney tumours; bladder tumours;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Laissy, JP Hop Bichat, Serv Radiol, 46 Rue Henri Huchard, F-75018 Paris, France Hop Bichat 46 Rue Henri Huchard Paris France F-75018 s, France
Citazione:
J.P. Laissy et al., "IVU, an examination of the past without a future?", PROG UROL, 11(3), 2001, pp. 552-561

Abstract

IVU has been gradually replaced over recent years as the "gold standard" investigation for the renal parenchyma and urinary tract by two new modalities: ultrasound and computed tomography. Some authors still advocate IVU forthe assessment of renal colic, for the following reasons: the excess cost of CT (which is not true for plain CT) and the absence of functional data (there are specific CT signs for increased pressure). However the advantagesof CT are clearly established: contrast resolution allowing the detection of almost all stones except for certain complications of triple combinationtherapy in HIV seropositive patients, extensive cover facilitating identification of differential diagnoses, rapidity and greater efficacy, and finally the absence of risk related to the injection of iodinated contrast agents in this indication. However the performance of CT may be more limited in certain situations: thin patients, or when the female genital tract also needs to be investigated, but IVU is not more contributive in this context. The current place of IVU in renal colic is therefore to establish a definitive diagnosis and to guide an urgent procedure (removal of an obstruction ina context of infection) when CT is either unavailable (maintenance...) or really, excessively irradiating, as in pregnant women, when ultrasound, or even MRI and MR urography have not been sufficiently contributive. The essential indication remains detailed visualization of the urinary tract (assessment of haematuria, detection of an urothelial tumour), detailed visualization of the entire urinary tract (assessment of certain malformations), or even a gross assessment of renal function in a patient with multiple injuries, which cannot be investigated by CT and in whom the surgeon rightly hesitates before opening the retroperitoneum. However in the absence of IVU, wemay fail to diagnose papillary necrosis or a small caliceal diverticulum, but is that really important in the final analysis? IVU, in countries with adapted equipment, is therefore now only an expert examination. IVU is an examination of the past, without a future indeed, but with a descendant: CT urography.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/09/20 alle ore 18:45:19