Yilmaz S, Sindel T, Arslan G, Ozkaynak C, Karaali K, Kabaalioğlu A, Lüleci E
Department of Radiology, Akdeniz University Medical Faculty, Arapsuyu, TR-07 070 Antalya, Turkey.
Eur Radiol. 1998;8(2):212-7. doi: 10.1007/s003300050364.
The aim of our study was to compare non-contrast spiral CT, US and intravenous urography (IVU) in the evaluation of patients with renal colic for the diagnosis of ureteral calculi. During a period of 17 months, 112 patients with renal colic were examined with spiral CT, US and IVU. Fifteen patients were lost to follow-up and excluded. The remaining 97 patients were defined to be either true positive or negative for ureterolithiasis based on the follow-up data. Sensitivity, specificity, positive and negative predictive value and accuracy of spiral CT, US and IVU were determined, and secondary signs of ureteral stones and other pathologies causing renal colic detected with these modalities were noted. Of 97 patients, 64 were confirmed to have ureteral calculi based on stone recovery or urological interventions. Thirty-three patients were proved not to have ureteral calculi based on failure to recover a stone and diagnoses unrelated to ureterolithiasis. Spiral CT was found to be the best modality for depicting ureteral stones with a sensitivity of 94 % and a specificity of 97 %. For US and IVU, these figures were 19, 97, 52, and 94 %, respectively. Spiral CT is superior to US and IVU in the demonstration of ureteral calculi in patients with renal colic, but because of its high cost, higher radiation dose and high workload, it should be reserved for cases where US and IVU do not show the cause of symptoms.
我们研究的目的是比较非增强螺旋CT、超声和静脉肾盂造影（IVU）在评估肾绞痛患者输尿管结石诊断中的作用。在17个月的时间里，对112例肾绞痛患者进行了螺旋CT、超声和IVU检查。15例患者失访并被排除。根据随访数据，将其余97例患者定义为输尿管结石真阳性或阴性。确定了螺旋CT、超声和IVU的敏感性、特异性、阳性和阴性预测值及准确性，并记录了这些检查方式检测到的输尿管结石的间接征象以及导致肾绞痛的其他病变。97例患者中，64例根据结石排出或泌尿外科干预证实有输尿管结石。33例患者根据未排出结石及与输尿管结石无关的诊断被证明没有输尿管结石。发现螺旋CT是显示输尿管结石的最佳检查方式，敏感性为94%，特异性为97%。对于超声和IVU，这些数字分别为19%、97%、52%和94%。在显示肾绞痛患者的输尿管结石方面，螺旋CT优于超声和IVU，但由于其成本高、辐射剂量大及工作量大，应仅用于超声和IVU未显示症状原因的病例。
