[Evaluation of non-enhanced spiral CT in the assessment of renal colic: prospective series of 81 patients].
OBJECTIVE
For many years, intravenous urography has been the first-line investigation for renal colic. Since the middle of the 1990s, non-enhanced spiral CT has become a more efficient, less invasive and less expensive alternative to IVU. The aim of this study was to compare non-enhanced spiral CT and IVU in the assessment of renal colic and to evaluate the possibility of exclusive CT assessment in this disease.


METHODS
Prospective study including 81 patients all undergoing urgent non-enhanced spiral CT, while the first 30 patients were investigated by non-enhanced spiral CT and IVU.


RESULTS
Comparison of IVU versus CT: better sensitivity of CT for the diagnosis of renal colic (96% vs 92%) and for the detection of stones (95% vs 59%). CT diagnosis: A definitive diagnosis of renal colic was established in 72/81 patients: stone visualized in 64 cases and post colic syndrome in 8 cases, while the other 9 patients presented a non-urological abdominal disease.


CONCLUSIONS
Comparison of our series with results reported in the literature confirms the superiority of CT over IVU with better visualization of the stone at a lower cost, with a shorter examination time, without injection and allowing the detection of non-urological disease. Analysis of CT signs emphasizes the importance of secondary signs for the diagnosis of renal colic (dilatation, perirenal or ureteric oedema, rim sign). Delayed excretion demonstrated by IVU and not directly evaluable by non-enhanced CT is no longer an argument in favour of IVU as first-line examination for the assessment of renal colic.


CONCLUSIONS
The superiority of CT for the diagnosis of renal colic has now been demonstrated. Renal colic can now be assessed exclusively by first-line non-enhanced helical CT. IVU or contrast-enhanced CT may be indicated in rare cases when there is a doubt about the diagnosis on non-enhanced CT.
Anfossi
Eric
E
Service d'Urologie, Hôpital Nord, Chemin des Bourrelys, 13015 Marseille. e.anfossi@mail.ap-hm.fr
Eghazarian
Christophe
C
Portier
François
F
Prost
Jérôme
J
Ragni
Evelyne
E
Daou
Nabil
N
Rossi
Dominique
D
D000328:Adult; D000465:Algorithms; D003085:Colic / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging*; D008297:Male; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*
Evaluation du scanner hélicoïdal non injecté dans la prise en charge des coliques néphrétiques: série prospective de 81 malades.