Jackman S V, Potter S R, Regan F, Jarrett T W
James Buchanan Brady Urological Institute and Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
J Urol. 2000 Aug;164(2):308-10.
Urolithiasis followup with plain abdominal x-ray requires adequate visualization of the calculus on the initial x-ray or computerized tomography (CT) study. We compared the sensitivity of plain abdominal x-ray versus CT for stone localization after positive nonenhanced spiral CT.
We evaluated 46 consecutive nonenhanced spiral CT studies positive for upper urinary tract lithiasis for which concurrent plain abdominal x-rays were available. X-ray and CT studies were compared for the ability to visualize retrospectively a stone given its location by CT. A consensus of 1 radiologist and 3 urologists was reached in each case. Cross-sectional stone size and maximum length were measured on plain abdominal x-ray.
Plain abdominal x-ray and scout CT had 48% (22 of 46 cases) and 17% (8 of 46) sensitivity, respectively, for detecting the index stone (p <0.00004). Of the 39 stones overall visualized on plain abdominal x-ray only 19 (49%) were visualized on scout CT. Mean cross-sectional area and length of the stones on scout CT were 0.34 cm.2 (approximately 6 x 5.5 mm.) and 6. 5 mm., respectively, while the average size of those missed was 0.11 cm.2 (approximately 4 x 3 mm.) and 3.6 mm. The mean size differences in the groups were highly significant (p <0.0009).
Plain abdominal x-ray is more sensitive than scout CT for detecting radiopaque nephrolithiasis. Of the stones visible on plain abdominal x-ray 51% were not seen on CT. To facilitate outpatient clinic followup of patients with calculi plain abdominal x-ray should be performed when a stone is not clearly visible on scout CT.
采用腹部平片对尿路结石进行随访时，需要在初始X线或计算机断层扫描（CT）检查中清晰显示结石。我们比较了腹部平片与CT在非增强螺旋CT检查发现结石阳性后对结石定位的敏感性。
我们评估了46例连续的非增强螺旋CT检查结果为上尿路结石阳性且同时有腹部平片的患者。根据CT显示的结石位置，比较X线和CT检查对结石的回顾性显示能力。每例均由1名放射科医生和3名泌尿科医生达成共识。在腹部平片上测量结石的横截面积和最大长度。
腹部平片和CT平扫对索引结石的检测敏感性分别为48%（46例中的22例）和17%（46例中的8例）（p<0.00004）。在腹部平片上总共显示的39颗结石中，只有19颗（49%）在CT平扫上可见。CT平扫上结石的平均横截面积和长度分别为0.34平方厘米（约6×5.5毫米）和6.5毫米，而未被发现的结石平均大小为0.11平方厘米（约4×3毫米）和3.6毫米。两组之间的平均大小差异具有高度统计学意义（p<0.0009）。
腹部平片在检测不透X线的肾结石方面比CT平扫更敏感。在腹部平片上可见的结石中有51%在CT上未被发现。为便于对结石患者进行门诊随访，当结石在CT平扫上显示不清晰时，应进行腹部平片检查。
