Comparison between ultrasound and noncontrast helical computed tomography for identification of acute ureterolithiasis in a teaching hospital setting

Sao Paulo Medical Journal

Luís Ronan Marquez Ferreira De Souza¹  Suzan Menasce Goldman¹  Salomão Faintuch¹  Juliano Ferreira Faria¹  Daniel Bekhor¹  Dario Ariel Tiferes¹  Valdemar Ortiz¹  Peter Choyke¹  Jacob Szejnfeld¹ 

[1] ,Universidade Federal de São Paulo Escola Paulista de Medicina Diagnostic Imaging DepartmentSão Paulo,Brazil

关键词: Spiral computed tomography;    Ultrasonography;    Ureteral calculi;    Lithiasis;    Flank pain;    Tomografia computadorizada espiral;    Ultra-sonografia;    Cálculos ureterais;    Litíase;    Dor no flanco;   

DOI  :  10.1590/S1516-31802007000200007

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Recent studies have shown noncontrast computed tomography (NCT) to be more effective than ultrasound (US) for imaging acute ureterolithiasis. However, to our knowledge, there are few studies directly comparing these techniques in an emergency teaching hospital setting. The objectives of this study were to compare the diagnostic accuracy of US and NCT performed by senior radiology residents for diagnosing acute ureterolithiasis; and to assess interobserver agreement on tomography interpretations by residents and experienced abdominal radiologists. DESIGN AND SETTING: Prospective study of 52 consecutive patients, who underwent both US and NCT within an interval of eight hours, at Hospital São Paulo. METHODS: US scans were performed by senior residents and read by experienced radiologists. NCT scan images were read by senior residents, and subsequently by three abdominal radiologists. The interobserver variability was assessed using the kappa statistic. RESULTS: Ureteral calculi were found in 40 out of 52 patients (77%). US presented sensitivity of 22% and specificity of 100%. When collecting system dilatation was associated, US demonstrated 73% sensitivity, 82% specificity. The interobserver agreement in NCT analysis was very high with regard to identification of calculi, collecting system dilatation and stranding of perinephric fat. CONCLUSIONS: US has limited value for identifying ureteral calculi in comparison with NCT, even when collecting system dilatation is present. Residents and abdominal radiologists demonstrated excellent agreement rates for ureteral calculi, identification of collecting system dilatation and stranding of perinephric fat on NCT.

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