Diagnostic validity of helical CT compared to ultrasonography in renal-ureteral colic.
OBJECTIVE
Helical CT without contrast is currently being evaluated for the diagnosis of renoureteral colic. Ureteral obstruction and other pathologies with similar symptoms can be rapidly identified. This study intends to evaluate the validity of CTh for these patients and to compare it with the ultrasound technique in order to consider the CTh as an efficient diagnostic alternative for these pathologies.


METHODS
A diagnostic evaluation study was carried out between January 2004 and December 2006 in patients with persistent renoureteral colic after standard care. They were blindly evaluated by ultrasound and CTh, maintaining the follow up until the "gold standard" confirmation. Qualitative variables were described by frequency and 95%CI and quantitative variables by position and dispersion measures. The Chi2 test was used to compare qualitative variables. Validity indicators and 95% CI were calculated and compared with McNemar test.


RESULTS
124 patients were studied. Lithiasis and the other diagnosis had frequencies of 59.7% and 40.3% respectively. The percentage of lithiasis obtained by ultrasound (92) was 22.8% and by CTh (124) was 59.7%. Validity indicators for CTh were superior to 95%, with 100% sensitivity and positive predictive value. Ultrasound specificity and positive predictive value were 100%, but sensitivity was only 29.6% (p<0.05).


CONCLUSIONS
CTh can be considered a good alternative diagnostic technique in the renoureteral colic management.
Rengifo Abbad
Diego
D
Urology Department, University Hospital Fundacion Alcorcon, Alcorcon, Madrid, Spain. drengifo22@yahoo.es
Rodríguez Caravaca
Gil
G
Barreales Tolosa
Laura
L
Villar del Campo
María Concepción
MC
Martel Villagrán
José
J
Trapero García
Miguel Angel
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D036542:Tomography, Spiral Computed; D014463:Ultrasonography; D014514:Ureteral Calculi / Q000000981:diagnostic imaging*; D055815:Young Adult