Non-contrast-enhanced helical computed tomography for the evaluation of patients with acute flank pain
P J Dorio1, M A Pozniak, F T Lee
1University of Wisconsin, Department of Radiology, Madison, USA.
Abstract:
The purpose of this study was to determine the sensitivity, specificity, and positive predictive value of non-contrast-enhanced helical CT as the primary imaging modality for the evaluation of patients with acute flank pain at the University of Wisconsin. A retrospective review of 163 computed tomography (CT) examinations, dating from 3/4/97 to 3/25/98, was performed. Statistical calculations were performed using only clinically-confirmed data. Sixty-five true positives, 3 false positives, 64 true negatives, and 1 false negative yield a sensitivity of 98.5%, a specificity of 95.5%, and a positive predictive value of 95.6%. A timely diagnosis of non-genitourinary system pathology occurred in 7% of cases, improving the overall efficacy of this modality for the evaluation of flank pain. The University of Wisconsin experience confirms the accuracy and efficacy of using non-contrast-enhanced helical CT in the diagnosis of a suspected obstructing ureteral calculus. The highly accurate and timely diagnosis of an obstructing ureteral calculus, or of extraurinary tract pathology, establishes non-contrast-enhanced helical CT as the diagnostic study of choice for the evaluation of the patient with acute flank pain.
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