[Unenhanced spiral CT in urolithiasis: indication, performance and interpretation]

Area of Science:

• Radiology
• Urology
• Medical Imaging

Background:

• Acute flank pain evaluation often involves imaging to detect urinary tract calculi.
• Traditional methods like plain radiographs and excretory urography have limitations in accuracy and detail.

Purpose of the Study:

• To assess the efficacy of unenhanced spiral computed tomography (CT) in diagnosing urinary tract calculi.
• To evaluate CT's ability to determine stone characteristics and identify alternative diagnoses for flank pain.

Main Methods:

• Utilized unenhanced spiral CT scans for patients presenting with acute flank pain.
• Analyzed CT images for the presence, size, location, and composition of urinary calculi.
• Assessed for secondary signs of obstruction and other potential causes of flank pain.

Main Results:

• Unenhanced spiral CT demonstrated high accuracy in depicting urinary tract calculi, surpassing conventional imaging modalities.
• The technique successfully detected various stone compositions, including uric acid, xanthine, and cystine.
• CT identified secondary signs of obstruction (e.g., renal collecting system dilatation) and frequently diagnosed alternative pathologies.

Conclusions:

• Unenhanced spiral CT is a superior imaging tool for acute flank pain, offering accurate calculi detection and characterization.
• This method aids in predicting stone composition and identifying non-urolithiasis causes of pain.
• CT imaging effectively guides subsequent management decisions for patients with acute flank pain.