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.

Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones

“…In the present study, the gray-scale Ultrasound sensitivity and specificity increased significantly when CDU was used with twinkling, where 99.6% of stones could be located with great confidence which is similar to results of recent studies (5,9). Regarding the echographic identification of ureterolithiasis, there are numerous studies with quite contradictory results and with a very wide range of values, the sensitivity of the method ranging between 19% and 96% (16)(17)(18). Our study showed the echographic identifications of ureteral calculi in 65.4% only.…”

The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients

“…Ultrasonography (US) is an imaging modality that may be used to investigate renal colic that does not expose the patient to radiation or contrast material. 19 Although reported estimates of the sensitivity of US to visualize ureteral calculi vary widely and are lower than that of CT (12%-93%), 20,21 US is highly accurate in detecting hydronephrosis, perinephric fluid and abnormal urinary jets, which often indicate the presence of calculi with sensitivity nearing 100%. 22,23 The specificity of US for direct or indirect findings compatible with ureterolithiasis is greater than 90% in some studies.…”

“…22,23 The specificity of US for direct or indirect findings compatible with ureterolithiasis is greater than 90% in some studies. 15,21,24 Additionally, US has been recognized as a useful imaging tool for patients in whom radiation exposure should be avoided. 25 The objective of this study was to determine the ability of US to identify renal colic patients with a low risk of requiring urologic intervention within 90 days of their initial ED visit.…”

Focused Ultrasonic Propulsion of Kidney Stones: Review and Update of Preclinical Technology

“…[16][17][18][19][20][21][22] To determine the performance characteristics of the Verasonics imaging system, renal ultrasound images were obtained in nine human stone formers with 17 renal units. Ultrasound images of the upper, middle, lower poles, and the renal pelvis/UPJ were evaluated for stones by blinded reviewers and compared to recent CT imaging (within 60 days), which demonstrated a total of 27 stones with a mean size of 4.4 -3.3 mm.…”