RENAL COLIC - COMPARISON OF SPIRAL CT, US AND IVU IN THE DETECTION OFURETERAL CALCULI

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.