Nonenhanced helical CT and US in the emergency evaluation of patients with renal colic: prospective comparison.

Published

Journal Article

PURPOSE: To compare nonenhanced helical computed tomography (CT) with ultrasonography (US) for the depiction of urolithiasis. MATERIALS AND METHODS: During 9 months, 45 patients (mean age, 44 years; mean weight, 92.5 kg) prospectively underwent both nonenhanced helical CT (5-mm collimation; pitch of 1.5) and US of the kidneys, ureters, and bladder. US evaluation included a careful search for ureteral calculi. Presence of calculi and obstruction and incidental diagnoses were recorded. Clinical, surgical, and/or imaging follow-up data were obtained in all patients. The McNemar test was used to compare groups. RESULTS: Diagnoses included 23 ureteral calculi and one each of renal cell carcinoma, appendicitis, ureteropelvic junction obstruction, renal subcapsular hematoma, cholelithiasis, medullary calcinosis, and myelolipoma. CT depicted 22 of 23 ureteral calculi (sensitivity, 96%). US depicted 14 of 23 ureteral calculi (sensitivity, 61%). Differences in sensitivity were statistically significant (P: =.02). Specificity for each technique was 100%. When modalities were compared for the detection of any clinically relevant abnormality (eg, unilateral hydronephrosis and/or urolithiasis in patients with an obstructing calculus), sensitivities of US and CT increased to 92% and 100%, respectively. One case of appendicitis was missed at US, whereas medullary calcinosis and myelolipoma were missed at CT. CONCLUSION: Nonenhanced CT has a higher sensitivity for the detection of ureteral calculi compared with US.

Full Text

Duke Authors

Cited Authors

  • Sheafor, DH; Hertzberg, BS; Freed, KS; Carroll, BA; Keogan, MT; Paulson, EK; DeLong, DM; Nelson, RC

Published Date

  • December 2000

Published In

Volume / Issue

  • 217 / 3

Start / End Page

  • 792 - 797

PubMed ID

  • 11110945

Pubmed Central ID

  • 11110945

International Standard Serial Number (ISSN)

  • 0033-8419

Digital Object Identifier (DOI)

  • 10.1148/radiology.217.3.r00dc41792

Language

  • eng

Conference Location

  • United States