Zusammenfassung
Die Bildgebung ist ein wichtiger Aspekt für die Diagnostik und Therapieplanung von Patienten mit bekannten oder vermuteten Harnsteinen und gibt Hinweise zu Steingröße, Lokalisation und Dichte. Es gibt verschiedene bildgebende Verfahren, die für die Diagnostik der Urolithiasis verwendet werden können. Die Bildgebung der Urolithiasis hat sich über die Jahre substanziell weiterentwickelt. Früher waren konventionelle Röntgenaufnahmen und die intravenöse Pyelographie (IVP) die Bildgebungsmethoden der Wahl für Diagnose und Nachsorge. Diese Modalitäten wurden weitgehend durch die native Low-dose-Computertomographie (CT) des Abdomens und Beckens sowie durch den Ultraschall ersetzt. Obwohl das Low-dose-CT und der Ultraschall deutliche Verbesserungen gegenüber den herkömmlichen Bildgebungsmodalitäten aufweisen, haben auch sie Limitationen. Die ideale bildgebende Untersuchungsmethode zur Beurteilung von Harnsteinen wäre schnell durchgeführt, mit einer hohen Sensitivität und Spezifität, hochgradig reproduzierbar und ohne Strahlenbelastung. In diesem Kapitel werden die aktuellen bildgebenden Verfahren zur Beurteilung der Urolithiasis vorgestellt, deren Vor- und Nachteile diskutiert sowie Empfehlungen für den klinischen Einsatz gegeben.
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Literatur
Abdel-Gawad M, Kadasne RD, Elsobky E, Ali-El-Dein B, Monga M (2016) A prospective comparative study of color doppler ultrasound with twinkling and noncontrast computerized tomography for the evaluation of acute renal colic. J Urol 196(3):757–762. https://doi.org/10.1016/j.juro.2016.03.175
Cabrera FJ, Kaplan AG, Youssef RF, Tsivian M, Shin RH, Scales CD, Preminger GM, Lipkin ME (2016) Digital Tomosynthesis: a viable alternative to noncontrast computed tomography for the follow-up of nephrolithiasis? J Endourol 30(4):366–370. https://doi.org/10.1089/end.2015.0271
Dai JC, Dunmire B, Liu Z, Sternberg KM, Bailey MR, Harper JD, Sorensen MD (2018a) Measurement of posterior acoustic stone shadow on ultrasound is a learnable skill for inexperienced users to improve accuracy of stone sizing. J Endourol 32(11):1033–1038. https://doi.org/10.1089/end.2018.0577
Dai JC, Dunmire B, Sternberg KM, Liu Z, Larson T, Thiel J, Chang HC, Harper JD, Bailey MR, Sorensen MD (2018b) Retrospective comparison of measured stone size and posterior acoustic shadow width in clinical ultrasound images. World J Urol 36(5):727–732. https://doi.org/10.1007/s00345-017-2156-8
El-Wahab OA, El-Tabey MA, El-Barky E, El-Baky SA, El-Falah A, Refaat M (2014) Multislice computed tomography vs. intravenous urography for planning supine percutaneous nephrolithotomy: a randomised clinical trial. Arab J Urol 12(2):162–167. https://doi.org/10.1016/j.aju.2013.11.005
den Harder AM, Willemink MJ, van Doormaal PJ, Wessels FJ, Lock M, Schilham AMR, Budde RPJ, Leiner T, de Jong PA (2018) Radiation dose reduction for CT assessment of urolithiasis using iterative reconstruction: a prospective intra-individual study. Eur Radiol 28(1):143–150. https://doi.org/10.1007/s00330-017-4929-2
Hasani SA, Fathi M, Daadpey M, Zare MA, Tavakoli N, Abbasi S (2015) Accuracy of bedside emergency physician performed ultrasound in diagnosing different causes of acute abdominal pain: a prospective study. Clin Imaging 39(3):476–479. https://doi.org/10.1016/j.clinimag.2015.01.011
Heidenreich A, Desgrandschamps F, Terrier F (2002) Modern approach of diagnosis and management of acute flank pain: review of all imaging modalities. Eur Urol 41(4):351–362. https://doi.org/10.1016/s0302-2838(02)00064-7
Ibrahim EH, Cernigliaro JG, Bridges MD, Pooley RA, Haley WE (2016) The capabilities and limitations of clinical magnetic resonance imaging for detecting kidney stones: a retrospective study. Int J Biomed Imaging 2016:4935656. https://doi.org/10.1155/2016/4935656
Jain R, Omar M, Chaparala H, Kahn A, Li J, Kahn L, Sivalingam S (2018) How accurate are we in estimating true stone volume? A comparison of water displacement, ellipsoid formula, and a ct-based software tool. J Endourol 32(6):572–576. https://doi.org/10.1089/end.2017.0937
Kadihasanoglu M, Marien T, Miller NL (2017) Ureteral stone diameter on computerized tomography coronal reconstructions is clinically important and under-reported. Urology 102:54–60. https://doi.org/10.1016/j.urology.2016.11.046
Metzler IS, Smith-Bindman R, Moghadassi M, Wang RC, Stoller ML, Chi T (2017) Emergency department imaging modality effect on surgical management of nephrolithiasis: a multicenter, randomized clinical trial. J Urol 197(3 Pt 1):710–714. https://doi.org/10.1016/j.juro.2016.09.122
Mills L, Morley EJ, Soucy Z, Vilke GM, Lam SHF (2018) Ultrasound for the diagnosis and management of suspected urolithiasis in the emergency department. J Emerg Med 54(2):215–220. https://doi.org/10.1016/j.jemermed.2017.09.020
Moesbergen TC, de Ryke RJ, Dunbar S, Wells JE, Anderson NG (2011) Distal ureteral calculi: US follow-up. Radiology 260(2):575–580. https://doi.org/10.1148/radiol.11101077
Nestler T, Haneder S, Grosse Hokamp N (2019a) Modern imaging techniques in urinary stone disease. Curr Opin Urol 29(2):81–88. https://doi.org/10.1097/MOU.0000000000000572
Nestler T, Nestler K, Neisius A, Isbarn H, Netsch C, Waldeck S, Schmelz HU, Ruf C (2019b) Diagnostic accuracy of third-generation dual-source dual-energy CT: a prospective trial and protocol for clinical implementation. World J Urol 37(4):735–741. https://doi.org/10.1007/s00345-018-2430-4
Poletti PA, Platon A, Rutschmann OT, Schmidlin FR, Iselin CE, Becker CD (2007) Low-dose versus standard-dose CT protocol in patients with clinically suspected renal colic. AJR Am J Roentgenol 188(4):927–933. https://doi.org/10.2214/AJR.06.0793
Ray AA, Ghiculete D, Pace KT, Honey RJ (2010) Limitations to ultrasound in the detection and measurement of urinary tract calculi. Urology 76(2):295–300. https://doi.org/10.1016/j.urology.2009.12.015
Ripolles T, Agramunt M, Errando J, Martinez MJ, Coronel B, Morales M (2004) Suspected ureteral colic: plain film and sonography vs unenhanced helical CT. A prospective study in 66 patients. Eur Radiol 14(1):129–136. https://doi.org/10.1007/s00330-003-1924-6
Sandhu MS, Gulati A, Saritha J, Nayak B (2018) Urolithiasis: comparison of diagnostic performance of digital tomosynthesis and ultrasound. Which one to choose and when? Eur J Radiol 105:25–31. https://doi.org/10.1016/j.ejrad.2018.05.017
Seitz C, Bach T, Bader M, Berg W, Knoll T, Neisius A, Netsch C, Nothacker M, Schmidt S, Schonthaler M, Siener R, Stein R, Straub M, Strohmaier W, Turk C, Volkmer B (2019) [Update of the 2Sk guidelines on the diagnostics, treatment and metaphylaxis of urolithiasis (AWMF register number 043–025): what is new?]. Urologe A 58(11):1304–1312. https://doi.org/10.1007/s00120-019-01033-7
Smith-Bindman R, Aubin C, Bailitz J, Bengiamin RN, Camargo CA Jr, Corbo J, Dean AJ, Goldstein RB, Griffey RT, Jay GD, Kang TL, Kriesel DR, Ma OJ, Mallin M, Manson W, Melnikow J, Miglioretti DL, Miller SK, Mills LD, Miner JR, Moghadassi M, Noble VE, Press GM, Stoller ML, Valencia VE, Wang J, Wang RC, Cummings SR (2014) Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med 371(12):1100–1110. https://doi.org/10.1056/NEJMoa1404446
Türk C SA, Neisius A, Petrik A, Seitz C, Thomas K (2019) EAU guideline on urolithiasis. Eur Association Urol
Weisenthal K, Karthik P, Shaw M, Sengupta D, Bhargavan-Chatfield M, Burleson J, Mustafa A, Kalra M, Moore C (2018) Evaluation of kidney stones with reduced-radiation dose CT: progress from 2011–2012 to 2015–2016-not there yet. Radiology 286(2):581–589. https://doi.org/10.1148/radiol.2017170285
Wilhelm K, Miernik A, Hein S, Schlager D, Adams F, Benndorf M, Fritz B, Langer M, Hesse A, Schoenthaler M, Neubauer J (2018) Validating automated kidney stone volumetry in computed tomography and mathematical correlation with estimated stone volume based on diameter. J Endourol. https://doi.org/10.1089/end.2018.0058
Worster A, Preyra I, Weaver B, Haines T (2002) The accuracy of noncontrast helical computed tomography versus intravenous pyelography in the diagnosis of suspected acute urolithiasis: a meta-analysis. Ann Emerg Med 40(3):280–286. https://doi.org/10.1067/mem.2002.126170
Xiang H, Chan M, Brown V, Huo YR, Chan L, Ridley L (2017) Systematic review and meta-analysis of the diagnostic accuracy of low-dose computed tomography of the kidneys, ureters and bladder for urolithiasis. J Med Imaging Radiat Oncol 61(5):582–590. https://doi.org/10.1111/1754-9485.12587
Zheng X, Liu Y, Li M, Wang Q, Song B (2016) Dual-energy computed tomography for characterizing urinary calcified calculi and uric acid calculi: a meta-analysis. Eur J Radiol 85(10):1843–1848. https://doi.org/10.1016/j.ejrad.2016.08.013
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Nestler, T. (2021). Bildgebung. In: Knoll, T., Miernik, A. (eds) Urolithiasis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62454-8_3
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