title: Non-contrast-enhanced helical computed tomography for the evaluation of patients with acute flank pain.
abstract: The purpose of this study was to determine the sensitivity, specificity, and positive predictive value of non-contrast-enhanced helical CT as the primary imaging modality for the evaluation of patients with acute flank pain at the University of Wisconsin. A retrospective review of 163 computed tomography (CT) examinations, dating from 3/4/97 to 3/25/98, was performed. Statistical calculations were performed using only clinically-confirmed data. Sixty-five true positives, 3 false positives, 64 true negatives, and 1 false negative yield a sensitivity of 98.5%, a specificity of 95.5%, and a positive predictive value of 95.6%. A timely diagnosis of non-genitourinary system pathology occurred in 7% of cases, improving the overall efficacy of this modality for the evaluation of flank pain. The University of Wisconsin experience confirms the accuracy and efficacy of using non-contrast-enhanced helical CT in the diagnosis of a suspected obstructing ureteral calculus. The highly accurate and timely diagnosis of an obstructing ureteral calculus, or of extraurinary tract pathology, establishes non-contrast-enhanced helical CT as the diagnostic study of choice for the evaluation of the patient with acute flank pain.
authors.affiliation: University of Wisconsin, Department of Radiology, Madison, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Dorio
authors.forename: M A
authors.initials: MA
authors.lastname: Pozniak
authors.forename: F T
authors.initials: FT
authors.lastname: Lee
authors.forename: J E
authors.initials: JE
authors.lastname: Kuhlman
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014514:Ureteral Calculi / Q000150:complications / Q000000981:diagnostic imaging*