Fielding J R, Steele G, Fox L A, Heller H, Loughlin K R
Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
J Urol. 1997 Jun;157(6):2071-3.
We determined the value of noncontrast enhanced spiral computerized tomography (CT) in the evaluation of suspected renal colic.
Thin section (5 mm.) noncontrast enhanced CT was used to evaluate 100 patients presenting to the emergency room with flank pain. The 55 patients with ureteral obstruction were followed at the urology outpatient clinic and by telephone interview, while 45 without ureteral obstruction were followed by telephone interview and chart review. Sensitivity, specificity, and positive and negative predictive values for CT were determined, with passage, retrieval or identification of a stone on a retrograde study considered the gold standard for diagnosis.
A total of 89 patients had adequate clinical followup to assess outcome accurately. Of 55 patients with ureteral obstruction on CT 11 underwent endoscopic stone removal, while 44 were treated conservatively with stone passage documented in 39. Of the 45 patients without ureteral stones identified 38 did not pass calculi and CT provided a definite diagnosis in 14. There was 1 false-negative study. The results yielded 98% sensitivity, 100% specificity, and 100% positive and 97% negative predictive values.
Noncontrast enhanced spiral CT was accurate and reliable in detecting obstructing ureteral calculi in patients with flank pain.
我们确定了非增强螺旋计算机断层扫描（CT）在疑似肾绞痛评估中的价值。
采用薄层（5毫米）非增强CT对100例因胁腹疼痛就诊于急诊室的患者进行评估。55例输尿管梗阻患者在泌尿外科门诊随访并通过电话访谈，45例无输尿管梗阻患者通过电话访谈和病历审查进行随访。以逆行检查中结石的排出、取出或识别作为诊断的金标准，确定CT的敏感性、特异性以及阳性和阴性预测值。
共有89例患者获得了充分的临床随访以准确评估结果。在CT显示输尿管梗阻的55例患者中，11例接受了内镜下取石，44例接受保守治疗，其中39例记录有结石排出。在45例未发现输尿管结石的患者中，38例结石未排出，CT在14例中提供了明确诊断。有1例假阴性检查。结果显示敏感性为98%，特异性为100%，阳性预测值为100%，阴性预测值为97%。
非增强螺旋CT在检测胁腹疼痛患者输尿管梗阻结石方面准确可靠。
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