HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Catalano, O. Articles by Siani, A. Search for Related Content PubMed PubMed Citation Articles by Catalano, O. Articles by Siani, A. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Suspected Ureteral Colic

Primary Helical CT Versus Selective Helical CT After Unenhanced Radiography and Sonography

¹ Department of Radiology, S. Maria delle Grazie Hospital, Via Domitiana Località La Schiana, Pozzuoli (Na), Italy.
² Present address: Via Crispi 92, Naples, I-80121, Italy.
³ Department of Diagnostic Imaging, PSI Napoli EST, Via Ciccarelli 1, Naples, I-80147, Italy.

OBJECTIVE. The purpose of this study was to compare the accuracy of unenhanced helical CT with combined sonography and unenhanced radiography in patients with acute flank pain suggestive of ureteral colic.

SUBJECTS AND METHODS. From January 1997 to December 1999, 181 consecutive patients with acute flank pain underwent unenhanced radiography, sonography, and unenhanced helical CT (protocol A). From January 2000 to December 2000, 96 consecutive patients arriving at the emergency department with acute flank pain were alternately submitted either to primary unenhanced helical CT (protocol B, 48 patients) or to unenhanced radiography and sonography with the addition of helical CT in unclear cases (protocol C, 48 patients).

RESULTS. When compared with the diagnostic accuracy for ureterolithiasis of the combined sonography and radiography in the same group of subjects (protocol A), CT had a greater sensitivity (92% vs 77%), negative predictive value (87% vs 68%), and overall accuracy (94% vs 83%). Among patients who underwent primary CT (protocol B), we found three false-negatives (all with spontaneous stone passage) and no false-positives. Among patients initially examined with unenhanced radiography and sonography (protocol C), we found one false-positive (leading to patient admission and needless repeated radiographic and sonographic studies) and six false-negatives (all followed by an uncomplicated course and spontaneous passage); CT depicted four of these stones but did not result in change in treatment. Fourteen percent of the patients in protocol C required invasive treatment, but combined sonography and radiography showed stones and hydronephrosis in all these patients.

CONCLUSION. Unenhanced CT was the most accurate modality for determining the presence of ureterolithiasis. The combination of abdominal radiography and sonography, however, yielded comparable results with no clinically important misdiagnoses and thus can be used as an alternative when CT resources are limited.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A. D. Bansal, J. Hui, and D. S. Goldfarb Asymptomatic Nephrolithiasis Detected by Ultrasound Clin. J. Am. Soc. Nephrol., March 1, 2009; 4(3): 680 - 684. [Abstract] [Full Text] [PDF]

				S. J. Park, B. H. Yi, H. K. Lee, Y. H. Kim, G. J. Kim, and H. C. Kim Evaluation of Patients With Suspected Ureteral Calculi Using Sonography as an Initial Diagnostic Tool: How Can We Improve Diagnostic Accuracy? J. Ultrasound Med., October 1, 2008; 27(10): 1441 - 1450. [Abstract] [Full Text] [PDF]

				E J HALL and D J BRENNER Cancer risks from diagnostic radiology Br. J. Radiol., May 1, 2008; 81(965): 362 - 378. [Abstract] [Full Text] [PDF]

				M. Memarsadeghi, C. Schaefer-Prokop, M. Prokop, T. H. Helbich, C. C. Seitz, I. M. Noebauer-Huhmann, and G. Heinz-Peer Unenhanced MDCT in Patients with Suspected Urinary Stone Disease: Do Coronal Reformations Improve Diagnostic Performance? Am. J. Roentgenol., August 1, 2007; 189(2): W60 - W64. [Abstract] [Full Text] [PDF]

				T. H. Mulkens, S. Daineffe, R. De Wijngaert, P. Bellinck, A. Leonard, G. Smet, and J.-L. Termote Urinary Stone Disease: Comparison of Standard-Dose and Low-Dose with 4D MDCT Tube Current Modulation Am. J. Roentgenol., February 1, 2007; 188(2): 553 - 562. [Abstract] [Full Text] [PDF]

				M. Mitterberger, G. M. Pinggera, E. Maier, H. Neuwirt, R. Neururer, L. Pallwein, J. Gradl, G. Bartsch, H. Strasser, and F. Frauscher Value of 3-Dimensional Transrectal/ Transvaginal Sonography in Diagnosis of Distal Ureteral Calculi J. Ultrasound Med., January 1, 2007; 26(1): 19 - 27. [Abstract] [Full Text] [PDF]

				S. I. Katz, S. Saluja, J. A. Brink, and H. P. Forman Radiation Dose Associated with Unenhanced CT for Suspected Renal Colic: Impact of Repetitive Studies. Am. J. Roentgenol., April 1, 2006; 186(4): 1120 - 1124. [Abstract] [Full Text] [PDF]

				M. Memarsadeghi, G. Heinz-Peer, T. H. Helbich, C. Schaefer-Prokop, G. Kramer, M. Scharitzer, and M. Prokop Unenhanced Multi-Detector Row CT in Patients Suspected of Having Urinary Stone Disease: Effect of Section Width on Diagnosis Radiology, May 1, 2005; 235(2): 530 - 536. [Abstract] [Full Text] [PDF]