Urinary calculus: IVU vs. CT renal stone? A critically appraised topic.

BACKGROUND

We wondered whether noncontrast CT performs better than the intravenous urogram (IVU) in the detection of urinary calculi.

METHODS

A comprehensive search of the literature was undertaken in order to answer the above question. Both primary and secondary sources of evidence were searched. The retrieved evidence was then appraised.

RESULTS

The strongest evidence was in a meta-analysis by Worster and colleagues (level 1a evidence according to the Oxford/CEBM levels of evidence). This was an analysis of four studies with a total of 296 patients who underwent intravenous urogram and noncontrast CT. This study shows that CT has better diagnostic performance than IVU for the detection of urinary stones.

CONCLUSIONS

The literature suggests that CT should be utilized in preference to IVU for patients with suspected urolithiasis.