title: Plain abdominal radiography with transabdominal native tissue harmonic imaging ultrasonography vs unenhanced computed tomography in renal colic.
abstract: OBJECTIVE
  To compare plain film kidney, ureter and bladder radiography (KUB) with transabdominal native tissue harmonic imaging ultrasonography (NTHI-US) vs unenhanced computed tomography (CT) for the diagnosis of urinary calculi in patients with acute flank pain.
  
  
  METHODS
  In all, 112 patients who presented to the urological department with clinical suspicion of ureteric calculi were included. These patients had KUB with NTHI-US and unenhanced CT. Of the 112 patients, 14 were lost to follow-up and therefore excluded. For the remaining 98 patients (53 men, 45 women; mean age 43.3 years, range: 19-74) the KUB with NTHI-US findings were compared with the CT findings, which served as the 'gold standard'.
  
  
  RESULTS
  In all, 75 patients were confirmed to have ureteric calculi. KUB with transabdominal NTHI-US detected 72 of the 75 patients with calculi (sensitivity 96%, specificity 91%, and accuracy 95%). Unenhanced CT detected urolithiasis in all 75 patients (sensitivity, specificity and accuracy of 100%). Both techniques showed further extra-urinary pathologies.
  
  
  CONCLUSIONS
  This prospective study shows that CT is the most accurate technique for detecting urolithiasis. However, KUB with transabdominal NTHI-US is an alternative to unenhanced CT with comparable results.
authors.affiliation: Department of Urology, Medical University Innsbruck, Austria. michael.mitterberger@uibk.ac.at
authors.forename: Michael
authors.initials: M
authors.lastname: Mitterberger
authors.forename: Germar Michael
authors.initials: GM
authors.lastname: Pinggera
authors.forename: Leo
authors.initials: L
authors.lastname: Pallwein
authors.forename: Johannes
authors.initials: J
authors.lastname: Gradl
authors.forename: Gudrun
authors.initials: G
authors.lastname: Feuchtner
authors.forename: Raffael
authors.initials: R
authors.lastname: Plattner
authors.forename: Richard
authors.initials: R
authors.lastname: Neururer
authors.forename: Georg
authors.initials: G
authors.lastname: Bartsch
authors.forename: Hannes
authors.initials: H
authors.lastname: Strasser
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Frauscher
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D011860:Radiography, Abdominal / Q000592:standards; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards*; D014463:Ultrasonography / Q000379:methods; D014514:Ureteral Calculi / Q000175:diagnosis* / Q000000981:diagnostic imaging