The role of unenhanced helical CT in the evaluation of suspected renal colic and atypical abdominal pain in children.
BACKGROUND
Urolithiasis in children has a different pattern of presentation than in adults and its incidence is lower. Unenhanced helical CT (UEHCT) for suspected urinary tract calculi in adults has high sensitivity and specificity for detecting even minute calculi. UEHCT has been proposed as a fast and sensitive method for identifying urinary stones in children. However, to our knowledge, the role of UEHCT and its value in the diagnostic work-up of urinary stones in children has not been studied.


OBJECTIVE
To evaluate the significance of UEHCT as a diagnostic tool for urinary stones in children.


METHODS
We retrospectively analysed data on 20 children who underwent UEHCT during 1999-2000.


RESULTS
Findings on UEHCT were significant in establishing a diagnosis in only seven patients and only three were shown to have urinary stones. Only one significant finding was found in the group who underwent UEHCT without prior US. US performed prior to UEHCT was a significant screening tool, and when results were equivocal, UEHCT further helped in establishing diagnosis.


CONCLUSIONS
We propose that US be the first imaging modality in children with suspected urolithiasis. When the result of this examination is uncertain or abnormal, UEHCT will probably add further information which will contribute to the diagnosis.
Eshed
Iris
I
Department of Diagnostic Radiology, Wolfon Medical Center, Holon, Israel. irisar@netvision.net.il
Witzling
Michaela
M
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003085:Colic / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014545:Urinary Calculi / Q000150:complications* / Q000000981:diagnostic imaging*