Document Detail


Suspected ureteral colic: primary helical CT versus selective helical CT after unenhanced radiography and sonography.
MedLine Citation:
PMID:  11804898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Orlando Catalano; Antonio Nunziata; Francesco Altei; Alfredo Siani
Related Documents :
10915668 - Helical ct of urinary calculi: effect of stone composition, stone size, and scan collim...
3947228 - Computed tomographic analysis of gallstones. an in vitro study.
10874178 - Interobserver agreement in the diagnosis of pulmonary embolism with helical ct.
9350718 - Optimal pitch in spiral computed tomography.
22213428 - Decoupled circular-polarized dual-head volume coil pair for studying two interacting hu...
10915668 - Helical ct of urinary calculi: effect of stone composition, stone size, and scan collim...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  178     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-01-23     Completed Date:  2002-02-25     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  379-87     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, S. Maria delle Grazie Hospital, Via Domitiana Località La Schiana, Pozzuoli (Na), Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Colic / radiography*,  ultrasonography*
Female
Humans
Male
Middle Aged
Prospective Studies
Tomography, X-Ray Computed / methods*
Ureteral Diseases / radiography*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  MR imaging of carcinoma of the vulva.
Next Document:  Videofluoroscopic assessment of patients with dysphagia: pharyngeal retention is a predictive factor...