title: Evaluation of acute renal colic: a comparison of non-contrast CT versus 3-T non-contrast HASTE MR urography.
abstract: With the introduction of a 3-T scanner, magnetic resonance urography (MRU) may be an alternative imaging modality for evaluation of acute renal colic. We performed a prospective study to compare the performance of computed tomography (CT) with half-Fourier single shot turbo spin-echo (HASTE) MRU in the evaluation of patients with suspected renal colic. Patients presenting to the emergency department with acute renal colic were eligible for inclusion. Following a standard CT stone evaluation, patients underwent a non-contrast HASTE MRU study with a 3-T scanner. The presence of perinephric fluid, hydronephrosis, ureteral obstruction, and calculus was assessed. A total of 22 patients completed the study. Twenty (91 %) were diagnosed with an upper tract stone by radiographic findings. MRU detected a discrete stone in 50 % of the patients with stones detected by CT. Perinephric fluid was noted in 12 MRUs, compared to 7 CTs. Using CT as the reference standard, the combination of stone or perinephric fluid and ureteral dilation gave MRU a sensitivity of 84 %, specificity of 100 %, and accuracy of 86 % (95 % CI 0.72-1.0). HASTE MRU with a 3-T MR scanner can reliably detect the presence of upper urinary tract obstruction. Although CT imaging remains the superior modality with which to detect calculi, MRU detects a greater number of secondary signs of upper tract obstruction. For situations in which the use of ionizing radiation is undesirable, MRU is a reasonable imaging alternative.
authors.affiliation: University of Pittsburgh Medical Center, Mercy Hospital, 1350 Locust Street Building C, Suite G100A, Pittsburgh, PA 15219, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Semins
authors.forename: Z
authors.initials: Z
authors.lastname: Feng
authors.forename: B
authors.initials: B
authors.lastname: Trock
authors.forename: M
authors.initials: M
authors.lastname: Bohlman
authors.forename: W
authors.initials: W
authors.lastname: Hosek
authors.forename: B R
authors.initials: BR
authors.lastname: Matlaga
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011446:Prospective Studies; D056844:Renal Colic / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014567:Urography / Q000379:methods*