| Suspected ureteral colic: primary helical CT versus selective helical CT after unenhanced radiography and sonography. | |
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MedLine Citation:
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PMID: 11804898 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Orlando Catalano; Antonio Nunziata; Francesco Altei; Alfredo Siani |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 178 ISSN: 0361-803X ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-01-23 Completed Date: 2002-02-25 Revised Date: 2008-02-15 |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 379-87 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, S. Maria delle Grazie Hospital, Via Domitiana Località La Schiana, Pozzuoli (Na), Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Colic / radiography*, ultrasonography* Female Humans Male Middle Aged Prospective Studies Tomography, X-Ray Computed / methods* Ureteral Diseases / radiography*, ultrasonography* |
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