Abstract Submission Form

Transcription

1 Abstract Submission Form All abstracts must be submitted to the AOCR by September 15 th. All information included must be the original work of the author(s) and be in typed form. Incomplete or handwritten abstracts will not be considered. At least one (1) author of the work or a designated representative must be present at the AOCR Annual Convention. An Integrated Sonographic Approach to Urolithiasis Primary Author and Affiliation: Val Smalley DO Arnot Ogden Medical Center Elmira, NY Additional Contributors: Dean Benjamin AOMC US Department Head Submission Category: Scientific Subspecialty Area: Genitourinary Radiology Trainees Only Training Program: Arnot Ogden Medical Center Supervising Faculty: Edwin Hustsal MD, Edwin Acosta MD, Gerald Buffo MD Please state any related disclosures or conflicts of interest: None Learning Objectives (3-5): -Be familiar with typical non-enhanced CT findings of an obstructing urinary calculus. -Be familiar with typical US gray scale findings of urinary tract obstruction. -Understand how the Renal parenchymal artery resistive index is obtained and what represents an elevated value (which may be seen with an obstructing calculus). -Be familiar with the appearance of ureteral jets on ultrasound. -Be familiar with how an obstructing urinary calculus may alter urinary jet characteristics (and if significant obstruction exists elevate the renal RI as well). this form: Narrative Abstract ( ) Five (5) PowerPoint slides with representative content that will be included in the exhibit. o The PowerPoint slides must contain images, but no more than two (2) tables/charts and five (5) embedded images. Please submit your form, narrative, and PowerPoint slides to Mary Lentz at the AOCR by ing mary@aocr.org.

2 An integrated sonographic approach to urolithiasis Val Smalley DO, Dean Benjamin; AOMC Radiology Attendings: Edwin Hustsal MD, Edwin Acosta MD, Gerald Buffo MD Abstract Purpose: Ultrasound evaluation of renal colic (grey scale, Duplex and Color Doppler) with emphasis on integrating ureteral jet characteristics (frequency, duration, peak velocity) and renal parenchymal artery Resistive Index (RI). Comparison of bilateral findings: ureteral jet characteristics will identify an obstructing calculus (potentially localize it); and the renal RI will determine if urinary obstruction is significant (RI > 0.7). Material and Methods: IRB-approved study enrolling 30 adult patients with urolithiasis initially identified by non-enhanced computed tomography (NECT) examination. Patients were subsequently oral hydrated (1L) and examined by ultrasound (sonographer uninformed regarding urolithiasis sidedness). Bilateral US evaluation: initial greyscale imaging of renal pelvis, ureter, and UVJ (calculus, twinkle artifact); subsequent renal parenchymal artery RI evaluation; followed by simultaneous Color Doppler imaging of both UVJs (jet frequency and duration); and lastly Duplex Doppler evaluation of UVJ peak velocity. Results: Sensitivity and Specificity of integrated US examination (Duplex and Color Doppler, grey scale) in identifying an obstructing urolith (CT reference standard). Calculation of individual ureteral jet individual characteristics in identifying an obstructing urolith (sensitivity, specificity, and cut-off values (p =.05). Estimation of relationship between individual ureteral jet characteristics and the renal parenchymal RI (regression analysis, RI = independent variable). Conclusion: An integrated US examination as described approaches the sensitivity of CT yet is able identify significant obstruction (renal parenchymal RI > 0.7) warranting intervention (stent placement). Determination of cut off values for individual ureteral jet characteristics facilitates implementation (95% confidence level). Minimal oral hydration, minimal sonographer proficiency, and overall 10 min examination time make this as an attractive alternative to the expense and radiation of CT (urolith initial identification or follow up).

3 Val Smalley DO, Dean Benjamin; AOMC Radiology Attendings: Edwin Hustsal MD, Edwin Acosta MD, Gerald Buffo MD

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