The outcome of computed tomography in patients with acute renal colic from a low-volume hospital.
OBJECTIVE
To assess the interobserver variability of unenhanced helical computed tomography (UHCT) in patients with acute renal colic admitted into a low-volume hospital.


METHODS
All admissions with acute renal colic between August 2002 and February 2004 (18 months) were registered. A total of 133 CT scans were performed on patients suspected of having a stone in the urinary tract (< 24 h after admission). All records were subsequently evaluated, the acute CT scans were re-evaluated by a radiological specialist. Interobserver agreements were assessed by means of Kappa analysis.


RESULTS
A total of 133 consecutive patients met the criteria for inclusion, of whom 62 were women and 71 were men. A total of 67 stones in 53 patients were identified. The variability of the radiological diagnosis (doctors under training and one consultant) was calculated, and the Kappa values were +0.66 and +0.69 for stones on the right and left side, respectively. The Kappa values for stones in ureter and the kidney were +0.79 and +0.52, respectively. In addition to stone disease, there were additional diagnoses in 30 patients (23%), out of whom seven had a malignant tumor.


CONCLUSIONS
In a low-volume hospital with fewer than 100 procedures a year, we found the UHCT method to be safe and reliable with a good interobserver agreement and Kappa value.
Lund
L
L
Department of Urology, Regionshospitalet Viborg, Viborg Hospital, 8800 Viborg, Denmark. Dr.LL@Dadlnet.dk
Larsen
U L
UL
Anderson
E
E
Mikkelsen
N T
NT
Holt
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003085:Colic / Q000000981:diagnostic imaging*; D005260:Female; D006766:Hospitals, County / Q000706:statistics & numerical data; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011872:Radiology Department, Hospital / Q000706:statistics & numerical data*; D013548:Sweden; D036542:Tomography, Spiral Computed