The aim of our study was to compare non-contrast spiral CT, US and int
ravenous urography (IVU) in the evaluation of patients with renal coli
c for the diagnosis of ureteral calculi. During a period of 17 months,
112 patients with renal colic were examined with spiral CT, US and IV
U. Fifteen patients were lost to follow-up and excluded. The remaining
97 patients were defined to be either true positive or negative for u
reterolithiasis based on the follow-up data. Sensitivity, specificity
positive and negative predictive value and accuracy of spiral CT, US a
nd IVU were determined, and secondary signs of ureteral stones and oth
er pathologies causing renal colic detected with these modalities were
noted. Of 97 patients, 64 were confirmed to have ureteral calculi bas
ed on stone recovery or urological interventions. Thirty-three patient
s were proved not to have ureteral calculi based on failure to recover
a stone and diagnoses unrelated to ureterolithiasis. Spiral CT was fo
und to be the best modality for depicting ureteral stones with a sensi
tivity of 94 % and a specificity of 97 %. For US and IVU, these figure
s were 19, 97, 52, and 94 %, respectively. Spiral CT is superior to US
and IVU in the demonstration of ureteral calculi in patients with ren
al colic, but because of its high cost, higher radiation dose and high
workload, it should be reserved for cases where US and IVU do not sho
w the cause of symptoms.