Abstract
This study was conducted to assess the diagnostic Ultrasonography compared to unenhanced helical CT scan in detecting urinary stones in patients with acute renal colic. This retrospective study comprised of 156 patients who undergo unenhanced urinary tract CT scan and ultrasonography for thought of urolithiasis. Both techniques were used to resolve the presence or absence, site, size, and number of urinary stones, as well as company of any other intra-abdominal pathology. For statistical analysis, the sensitivity, specificity, predictive values, and diagnostic accuracy of ultrasonography were deliberate considering unenhanced CT scan as a gold normal. Unpaired two-tailed student’s t-test was used for judgment between mean size of true positive, false positive, and false negative stones. There were 68 patients having 115 urinary stones. Ultrasound identified 54 stones, missed 43, and falsely diagnosed 18 stones. The mean size of true positive, false positive, and false negative stones were 4.8 ± 3.3 mm, 6 ± 1.8 mm and 4.18 ± 3 mm, respectively. There were 23 patients with other intra-abdominal pathologies, equally detected by both techniques. Ultrasound helped in identifying the cause of acute flank pain in 62% of cases. The overall sensitivity, specificity, positive and negative predictive values, and correctness of ultrasonography in the diagnosis of renal stone disease were 58%, 91%, 79%, 78%, and 78%, respectively. Our study suggests that, despite its limited value in detecting urinary stones, ultrasonography should be performed as an initial assessment in patients with acute flank pain. Unenhanced helical CT should be reserved for patients in whom ultrasonography is uncertain.
 Keywords: Ultrasonography, CT scan
Highlights
Acute renal colic is a common clinical problem and the investigation modalities have undergone transformation in the last decade, so that the choice of an initial diagnostic method is not always clear, when there is a contraindication to radiation exposure or, to intravenous injection of iodinated contrast material
This study was conducted to assess the diagnostic Ultrasonography compared to unenhanced helical CT scan in detecting urinary stones in patients with acute renal colic
This retrospective study comprised of 156 patients who undergo unenhanced urinary tract CT scan and ultrasonography for thought of urolithiasis
Summary
Acute renal colic is a common clinical problem and the investigation modalities have undergone transformation in the last decade, so that the choice of an initial diagnostic method is not always clear, when there is a contraindication to radiation exposure or, to intravenous injection of iodinated contrast material. The sensitivity of US for detection of urinary calculi is widely variable in the literature depending on the site and size of calculus, and on the patient morphology.[7,8] By the end of last century, unenhanced helical CT scan (UHCT) was introduced as a new imaging modality by Smith et al[9] for symbol of urinary stones, and was well accepted as an alternative method to IVU.[10] Nowadays, it is considered as the imaging modality of choice for this clinical entity.[11,12,13,14] Radiation dose, convenience, and high cost compared to US represent main confines of this technique. The objectives of our display study were to determine the role of B-Mode US in detecting urinary calculi and to contrast its diagnostic accuracy with the UHCT scan
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