Korean Journal of Radiology

  • 제2권1호
  • /
  • Pages.14-20
  • /
  • 2001
  • /
  • 1229-6929(pISSN)
  • /
  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지

Unenhanced Spiral CT in Acute Ureteral Colic: A Replacement for Excretory Urography?

  • Jeong-Ah Ryu (Department of Radiology, Samsung Medical Center, Sundkyunkwan University School of Medicine) ;
  • Bohyun Kim (Department of Radiology, Samsung Medical Center, Sundkyunkwan University School of Medicine) ;
  • Yong Hwan Jeon (Department of Radiology, Samsung Medical Center, Sundkyunkwan University School of Medicine) ;
  • Jongmee Lee (Department of Radiology, Samsung Medical Center, Sundkyunkwan University School of Medicine) ;
  • Jin-Wook Lee (Department of Radiology, Samsung Medical Center, Sundkyunkwan University School of Medicine) ;
  • Seong Soo Jeon (Department of Urology, Samsung Medical Center, Sundkyunkwan University School of Medicine) ;
  • Kwan Hyun Park (Department of Urology, Samsung Medical Center, Sundkyunkwan University School of Medicine)
  • 투고 : 2000.09.22
  • 심사 : 2001.01.07
  • 발행 : 2001.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To compare the usefulness of unenhanced spiral CT (UCT) with that of excretory urography (EU) in patients with acute flank pain. Materials and Methods: Thirty patients presenting with acute flank pain underwent both UCT and EU. Both techniques were used to determine the presence, size, and location of urinary stone, and the presence or absence of secondary signs was also evaluated. The existence of ureteral stone was confirmed by its removal or spontaneous passage during follow-up. The absence of a stone was determined on the basis of the clinical and radiological evidence. Results: Twenty-one of the 30 patients had one or more ureteral stones and nine had no stone. CT depicted 22 of 23 calculi in the 21 patients with a stone, and no calculus in all nine without a stone. The sensitivity and specificity of UCT were 96% and 100%, respectively. EU disclosed 14 calculi in the 21 patients with a stone and no calculus in eight of the nine without a stone. UCT and EU demonstrated secondary signs of ureterolithiasis in 15 and 17 patients, respectively. Conclusion: For the evaluation of patients with acute flank pain, UCT is an excellent modality with high sensitivity and specificity. In near future it may replace EU.

키워드

참고문헌

  1. Sierakowski R, Finlayson B, Landes RR, et al. The frequency of urolithiasis in hospital discharge diagnoses in the United States. Invest Urol 1978;15:438-441
  2. Miller OF, Rineer SK, Reichard SR, et al. Prospective comparison of unenhanced spiral computed tomography and intravenous urogram in the evaluation of acute flank pain. Urology 1998;52:982-987
  3. Levine JA, Neitlich J, Verga M, Dalrymple N, Smith RC. Ureteral calculi in patients with flank pain: correlation of plain radiography with unenhanced helical CT. Radiology 1997;204:27-31
  4. Smith RC, Ronsenfield AT, Choe KA, et al. Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography. Radiology 1995;194:789-794
  5. Miller OF, Kane CJ. Unenhanced helical computed tomography in the evaluation of acute flank pain. Current Opin Urol 2000;10:123-129
  6. Dalymple NC, Verga M, Anderson KR, et al. The value of unenhanced helical computed tomography in the management of acute flank pain. J Urol 1998;159:735-74
  7. Smith RC, Verga M, McCarthy S, Rosenfield AT. Acute ureteral obstruction: value of secondary signs of helical unenhanced CT. AJR 1996;167:1109-1113
  8. Heneghan JP, Dalrymple NC, Verga M, Rosenfield AT, Smith RC. Soft tissue "rim" sign in the diagnosis of ureteral calculi with use of unenhanced helical CT. Radiology 1997;202:709-711
  9. Kawashima A, Sandler CM, Boridy IC, et al. Unenhanced helical CT of ureterolithiasis: value of the tissue rim sign. AJR 1997;168:997-1000
  10. Boridy IC, Nikloaidis P, Kawashima A, Sandler CM, Goldman SM. Noncontrast helical CT for ureteral stones. World J Urol 1998;16:18-21
  11. Boulay I, Holtz P, Foley WD, White B, Begun FP. Ureteral calculi: diagnostic efficacy of helical CT and implications for treatment of patients. AJR 1999;172:1485-1490
  12. Niall O, Russel J, McGregor R, Duncan H, Mullins J. A comparison of noncontrast computed tomography with excretory urography in the assessment of acute flank pain. J Urol 1999;161:534-537
  13. Fielding JR, Steele G, Fox LA, Heller H, Loughlin KR. Spiral computed tomography in the evaluation of acute flank pain: a replacement for excretory urography. J Urol 1997;157:2071-2073
  14. Chen MYM, Zagoria RJ. Can noncontrast helical computed tomography replace intravenous urography for evaluation of patients with acute urinary tract colic? J Emerg Med 1999;17:299-303
  15. Yilmaz S, Sindel T, Arslan G, et al. Renal colic: comparison of spiral CT, US and IVU in the detection of ureteral calculi. Eur Radiol 1998;8:212-217
  16. Sommer FG, Jeffrey RB Jr., Rubin GD, et al. Detection of ureteral calculi in patients with suspected renal colic: value of reformatted noncontrast helical CT. AJR 1995; 165:509-513
  17. Denton ERE, Mackenzie A, Greenwell T, Popert R, Rankin SC. Unenhanced helical CT for renal colic: is the radiation dose justifiable? Clin Radiol 1999;54:444-447
  18. Vieweg J, The C, Freed K, et al. Unenhanced helical computed tomography for the evaluation of patients with acute flank pain. J Urol 1998;160:679-684
  19. Svedstrom E, Alanen A, Nurmi M. Radiologic diagnosis of renal colic: the role of plain films, excretory urography and sonography. Eur Radiol 1990;11:180-183
  20. Mutgy A, Williams JW, Nettleman M. Renal colic: utility of the plain abdominal roentgenogram. Arch Intern Med 1991;151:1589-1591
  21. Saita H, Matsukawa M, Fukushima H, Ohyama C, Nagata Y. Ultrasound diagnosis of ureteral stones: its usefulness with subsequent excretory urography. J Urol 1987;140:28-31
  22. Berland LL, Smith JK. Multidetector-array CT: Once again, technology creates new opportunities. Radiology 1998;209:327-329
  23. Hu H, He HD, Foley WD, et al. Four multidetector-row helical CT: image quality and volume coverage speed. Radiology 2000;215:55-62
  24. Kawashima A, Sandler CM, West O, et al. Detection of ureterolithiasis with unenhanced multidetector-array helical CT: comparison of 2.5-mm and 5.0-mm slice thickness. Radiology 2000;217(P):223