title: Suspected ureteral colic: plain film and sonography vs unenhanced helical CT. A prospective study in 66 patients.
abstract: The aim of this study was to compare the sensitivity and specificity of plain abdominal films plus ultrasound, vs nonenhanced CT for the diagnosis of ureteral colic in patients with acute flank pain. During a 4-month period, 66 patients (mean age 48 years) with acute flank pain were prospectively studied by means of plain abdominal film, US, and unenhanced CT. The presence of lithiasis and of obstructive uropathy signs were determined. The plain film was only used as a guide for the US exam. Clinical follow-up of all patients was obtained. Ureteral lithiasis was confirmed in 56 patients. The CT had a greater sensitivity (93 vs 79%) and negative predictive value (71 vs 46%) for the detection of lithiasis. The combination of lithiasis plus obstructive signs showed a sensitivity and a specificity of 100% for CT and of 100 and 90%, respectively, for US. The 11 lithiasis not detected by US were passed spontaneously (10 were <5 mm). Both techniques showed similar extraurinary pathology. Computed tomography is the most accurate technique for the detection of ureteral lithiasis; however, the combination of plain film and US is an alternative to nonenhanced CT with a lower sensitivity and radiation dose that has a good practical value.
authors.affiliation: Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain. ripolles_tom@gva.es
authors.forename: Tomás
authors.initials: T
authors.lastname: Ripollés
authors.forename: Marcos
authors.initials: M
authors.lastname: Agramunt
authors.forename: José
authors.initials: J
authors.lastname: Errando
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Martínez
authors.forename: Belén
authors.initials: B
authors.lastname: Coronel
authors.forename: María
authors.initials: M
authors.lastname: Morales
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003085:Colic / Q000000981:diagnostic imaging*; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography / Q000379:methods; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D036542:Tomography, Spiral Computed / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography; D014514:Ureteral Calculi / Q000000981:diagnostic imaging*