2182 ADEQUACY OF LOW DOSE COMPUTERIZED TOMOGRAPHY IN THE EVALUATION AND MANAGEMENT OF PATIENTS WITH ACUTE RENAL/URETERAL COLIC

Abstract

cluded from the study. Statistical analysis was performed using SPSS 15.0 for windows. RESULTS: Males: females ratio was 825 (87.9%):114(12.1%). Age range (mean /SD) was 9:80 years (37.9 11). Renal ultrasound (Grey-scale) alone detected calculi in 615 cases (65.4%) and by utilizing Color Doppler ultrasound using the twinkling sign the diagnosis was made with confidence in 935 cases (99.6 %) but 4 (0.4 %). The latter group was confirmed to have stones by helical CT. KUB showed stones in 503 (53.6%) cases and no stones in 436 (46.4 %). Microscopic hematuria was present in 835 (88.9 %) cases while 102 cases (10.9 %) were negative. There were 190 (20.3%), 77 (8.2%) and 671 (71.5%) cases with upper, middle and lower ureteral stones respectively. Right side stones were in 438 (46.7 %) cases and left side stones in 499 (53.3 %). Stones were bilateral in 4 cases (0.4%). Range of stones size (mean SD) was 3: 26 mm (7.5 2.7). The concomitant positive finding in US and KUB with microscopic hematuria was found only in 453 (48.2%) cases. US results were independent from any other factor while KUB results were significantly related to site, side, size of stones, age of patient and urine analysis (P 0.000,0.042,0.005,0.000, 0.016 respectively).Urine analysis results were related to stone size (P 0.008). CONCLUSIONS: The use of Color Doppler ultrasound and twinkling sign increased the detection rate of stone in acute renal colic presented to ER with less radiation exposure. Ultrasound examination as a single modality is superior to KUB and urine analysis in diagnosis of renal colic patients. The use of ultrasound and KUB in combination with urinalysis still has a role in diagnosis of renal colic, especially in areas where CT is not available. However, ultrasound is an operator dependent.