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Plain abdominal x-ray versus computerized tomography screening: sensitivity for stone localization after nonenhanced
S V Jackman1, S R Potter, F Regan
1James Buchanan Brady Urological Institute and Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
The Journal of Urology
|July 14, 2000
Summary
Plain abdominal x-rays are more sensitive than scout CT for detecting kidney stones. When a stone is not clearly visible on CT, plain abdominal x-rays are recommended for better follow-up of urolithiasis.
Area of Science:
- Radiology
- Urology
- Nephrology
Background:
- Urolithiasis (kidney stones) management requires accurate stone detection.
- Follow-up imaging for urolithiasis often relies on plain abdominal x-rays or CT scans.
- Adequate visualization of calculi is crucial for effective monitoring.
Purpose of the Study:
- To compare the sensitivity of plain abdominal x-rays versus CT for stone localization.
- To evaluate imaging modality effectiveness after a positive nonenhanced spiral CT scan for urolithiasis.
Main Methods:
- 46 patients with nonenhanced spiral CT positive for upper urinary tract lithiasis were analyzed.
- Plain abdominal x-rays were compared with CT for retrospective stone visualization.
- Stone size and length were measured on plain abdominal x-rays.
Main Results:
- Plain abdominal x-ray sensitivity was 48% (22/46), significantly higher than scout CT at 17% (8/46).
- Of stones visualized on plain x-ray, 51% were missed by scout CT.
- Missed stones on CT were significantly smaller than those detected.
Conclusions:
- Plain abdominal x-ray demonstrates superior sensitivity for detecting radiopaque nephrolithiasis compared to scout CT.
- Plain abdominal x-ray is recommended for follow-up when CT fails to clearly visualize stones.
- This aids in effective outpatient management of patients with kidney stones.