Comparision of Unenhanced Helical Computerized Tomography and Intravenous Urography in the Radiologic Evaluation of Acute Flank Pain / 대한비뇨기과학회지

ABSTRACT

PURPOSE: This study was conducted to compared unenhanced helical computerized tomography (CT) with intravenous urography (IVU) in the evaluation of acute flank pain. MATERIALS AND MTHODS Between April 2000 and April 2001, 59 patients with acute flank pain suspected of having urolithiasis underwent an unenhanced helical CT followed by an IVU. Two independent consultation urologic radiologists randomly assessed these patients for the presence, size and location of the calculus, ureteral dilatation and secondary sign of a ureteral obstruction. Of the 59 patients, 45 had a calculus confirmed on removal or a documented passage of a stone. The absence of a calculus was based on a clinical and radiological follow up with clinical resolution. RESULTS: CT revealed all 62 calculi from 45 patients and no calculus in 14 of the patients with a 98.4% sensitivity and a 100% specificity. IVU demonstrated 36 calculi from 35 patients and no calculus in 14 of the patients with a 57.1% sensitivity and a 100% specificity. Both CT and IVU demonstrated the secondary signs of a ureteral obstruction in 34 and 31 patients, respectively. The cost of the helical CT was 4-5 times higher than that of the IVU. CONCLUSIONS: Unenhanced helical CT is an accurate, safe, and a rapid technique for assessing acute flank pain and evaluate the choice for patients who would otherwise require a IVU for diagnosis but with a lower cost.