[Unenhanced spiral computerized tomography in acute diagnosis of flank pain. Examination in contraindications for contrast medium administration].
The diagnostic value of unenhanced helical computed tomography was investigated in a prospective study. In 53 patients (aged 35 to 82 years) with acute flank pain tomography was performed in addition to abdominal plain film and ultrasound examination. All 53 patients had a contraindication for intravenous administration of contrast medium. Ureteral calculi were either confirmed or excluded by retrograde ureteropyelography in 44 cases, in 9 patients by asservation of calculi and clinical follow-up. Helical computed tomography was able to precisely identify all of the 34 ureteral calculi, whereas abdominal plain films led to 6 false positive and 17 false negative findings. In 1 patient with retroperitoneal lymphoma (diagnosed by CT) false positive findings occurred. Unenhanced helical computed tomography reaches a distinctively increased diagnostic value (sensitivity 100%, specificity 95%, accuracy 97%) in the evaluation of acute flank pain as compared to conventional radiologic imaging and ultrasound. This non-invasive procedure is to be considered method of choice for patients with contraindications for the application of radiopaque material.
Hamm
M
M
Urologische Klinik, Klinikum Augsburg, Stenglinstrasse 2, 86156 Augsburg. hamm.m@web.de
Häckel
T
T
Wawroschek
F
F
Knöpfle
E
E
Häuser
H
H
Weckermann
D
D
Harzmann
R
R
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D021501:Flank Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014514:Ureteral Calculi / Q000000981:diagnostic imaging*
D003287:Contrast Media