Rodger Flora, Roditi Giles, Aboumarzouk Omar M
Urol Int. 2018;100(4):375-385. doi: 10.1159/000488062. Epub 2018 Apr 12.
Non-contrast computed tomography of the kidneys, ureters, and bladder (CT KUB) is the investigation of choice for renal colic; however, radiation exposure can be a concern.
The study aimed to investigate the diagnostic accuracy of low dose (LD) and ultra-low dose (ULD) CT of the urinary tract for detection of urinary tract stones in patients with renal colic.
A Cochrane style systematic review of the literature from 1995 to 2017 was carried out. Literature search and data extraction were conducted by 2 reviewers. Specificity and sensitivity values were calculated for LD (<3.5 mean radiation dose [mSv]) and ULD (<1.9 mSv) CT separately.
A total of 12 studies were included following screening. A total of 1,529 patients were included in the review (475 in the LD group and 1,054 in the ULD group). Using standard dose CT KUB as the reference standard, the sensitivity of LD CT KUB ranged from 90 to 98% and specificity from 88 to 100%. The sensitivity of ULD CT KUB ranged from 72 to 99% and the specificity ranged from 86 to 100%. The diagnostic accuracy for LD CT was 94.3% and for ULD CT was 95.5%.
LD and ULD CT KUB provide effective methods of identifying urinary tract stones. High diagnostic accuracy, sensitivity, and specificity are maintained despite significant radiation dose reduction in comparison to standard dose CT.
肾脏、输尿管和膀胱的非增强计算机断层扫描（CT KUB）是肾绞痛的首选检查方法；然而，辐射暴露可能令人担忧。
本研究旨在探讨低剂量（LD）和超低剂量（ULD）泌尿系统CT对肾绞痛患者尿路结石的诊断准确性。
对1995年至2017年的文献进行Cochrane风格的系统评价。由2名研究者进行文献检索和数据提取。分别计算LD（平均辐射剂量<3.5 mSv）和ULD（平均辐射剂量<1.9 mSv）CT的特异性和敏感性值。
筛选后共纳入12项研究。本评价共纳入1529例患者（LD组475例，ULD组1054例）。以标准剂量CT KUB作为参考标准，LD CT KUB的敏感性为90%至98%，特异性为88%至100%。ULD CT KUB的敏感性为72%至99%，特异性为86%至100%。LD CT的诊断准确性为94.3%，ULD CT的诊断准确性为95.5%。
LD和ULD CT KUB为识别尿路结石提供了有效的方法。与标准剂量CT相比，尽管辐射剂量显著降低，但仍保持了较高的诊断准确性、敏感性和特异性。
