Levine J A, Neitlich J, Verga M, Dalrymple N, Smith R C
Department of Diagnostic Imaging, Yale University School of Medicine, New Haven, CT 06510, USA.
Radiology. 1997 Jul;204(1):27-31. doi: 10.1148/radiology.204.1.9205218.
To determine the sensitivity and specificity of plain radiography for the detection of ureteral calculi with use of unenhanced helical computed tomography (CT) as the standard of reference.
Plain radiographs and helical CT scans of 178 patients with acute flank pain were reviewed retrospectively. Three interpretations of plain radiographs were used: (a) Original reading. This was the report made at the time of the patient's evaluation before the patient underwent CT. (b) Blinded retrospective reading. Each plain radiograph was interpreted without knowledge of the CT findings. (c) Unblinded retrospective reading. The plain radiograph of each patient whose CT scan showed a stone was reviewed with the CT scan.
The original reading had a sensitivity of 45% and a specificity of 77% for the detection of ureteral calculi. The blinded retrospective reading had a sensitivity of 59% and a specificity of 71%. The unblinded retrospective reading had a sensitivity of 59% (95% confidence interval: 47%, 70%).
Plain radiography is of limited value for aiding the diagnosis of ureteral stones. All patients with acute flank pain for whom radiologic imaging is recommended can directly undergo unenhanced helical CT; plain radiographs need not be obtained first.
以非增强螺旋计算机断层扫描（CT）作为参考标准，确定X线平片检测输尿管结石的敏感性和特异性。
回顾性分析178例急性腰痛患者的X线平片和螺旋CT扫描结果。对X线平片采用三种解读方式：（a）原始解读。这是患者在接受CT检查前进行评估时所做的报告。（b）盲法回顾性解读。在不了解CT检查结果的情况下对每张X线平片进行解读。（c）非盲法回顾性解读。对CT扫描显示有结石的每位患者的X线平片与CT扫描结果一起进行复查。
原始解读检测输尿管结石的敏感性为45%，特异性为77%。盲法回顾性解读的敏感性为59%，特异性为71%。非盲法回顾性解读的敏感性为59%（95%置信区间：47%，70%）。
X线平片对输尿管结石诊断的辅助价值有限。所有建议进行影像学检查的急性腰痛患者可直接接受非增强螺旋CT检查；无需先进行X线平片检查。
