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Noncontrast helical CT for ureteral stones
I C Boridy1, P Nikolaidis, A Kawashima
1Department of Radiology, University of Texas Health Science Center at Houston 77030, USA. iboridy@msrad3.med.uth.tmc.edu
World Journal of Urology
|May 16, 1998
Summary
Noncontrast helical computed tomography (CT) is superior for diagnosing ureteral stones compared to excretory urography (IVU). This imaging technique is faster, more sensitive, and detects additional pathologies, making it the preferred choice for flank pain evaluation.
Area of Science:
- Radiology
- Medical Imaging
- Urology
Background:
- Excretory urography (IVU) has been the standard for evaluating suspected ureterolithiasis.
- Noncontrast helical computed tomography (CT) offers potential advantages over IVU.
Purpose of the Study:
- To compare the efficacy of noncontrast helical CT with IVU in diagnosing ureteral calculi.
- To highlight the benefits and limitations of noncontrast CT in evaluating acute flank pain.
Main Methods:
- Review of noncontrast helical CT and IVU for suspected ureterolithiasis.
- Analysis of sensitivity, speed, and detection of extraurinary pathology.
Main Results:
- Noncontrast helical CT is more sensitive than IVU for detecting calculi of any size, location, or composition.
- Noncontrast CT often identifies extraurinary pathology and can be performed rapidly without contrast material.
- Differentiating ureteral calculi from phleboliths can be challenging; the "tissue-rim" sign aids distinction.
Conclusions:
- Noncontrast helical CT is the imaging study of choice for patients with acute flank pain and suspected ureterolithiasis.
- Despite higher costs and radiation dose, its diagnostic accuracy and speed outweigh limitations.