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Come si evidenziano i calcoli ?

Domande sulla calcolosi renale

Oggi giorno la facilità di reperire un ecografo consente facilmente la diagnosi di una calcolosi dell'apparato urinario.
In genere, è possibile eseguire anche una radiografia dell'addome che però ha molti più limiti della ecografia. Difatti qualsiasi esame radiografico (nel nostro caso la diretta renale) è ostacolato dal meteorismo (accumulo di area nell'intestino favorito dal blocco intestinale che c'è sempre nelle coliche renali e che in termine scientifico è detto ileo paralitico ) che disturba l'esame non consentendo la visualizzazione corretta del calcolo.
La radiografia diretta dell'addome non evidenzia poi calcoli di acido urico che sono radiotrasparenti.
In alcuni casi è necessario eseguire anche un'urografia, cioè una serie di radiografie dell'addome scattate dopo iniezione endovenosa di una sostanza (detta mezzo di contrasto ) che evidenzia i reni e le vie urinarie e che ci dà anche indicazioni sulla funzionalità del rene o meno.

Ma l'esame cardine è rappresentato dalla Tac senza mezzo di contrasto. Con questa , si potranno osservare tutti i calcoli indipendentemente dalla loro costituzione o dalla loro sede: in casi particolari sarà possibile anche qui , inserire un mezzo di contrasto endovena per perfezionare la diagnosi.

E' fondamentale, qualora il calcolo sia espulso o asportato, farlo analizzare in laboratorio.


Esami in caso di colica



Ecografia apparato urinario

Diretta renale (radiografia dell'addome)

Urografia (oggi più rara)

Tac spirale (esame cardine)

Esame delle urine con studio del sedimento

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