Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography.

TLDR

The study compares non‑contrast‑enhanced CT with intravenous urography for evaluating suspected ureteric obstruction in patients presenting with acute flank pain. Twenty patients with acute flank pain underwent both non‑contrast‑enhanced CT and IVU, and the imaging findings were compared for presence or absence of obstruction and stone delineation. Among the 20 patients, 12 had obstruction; of these, 5 stones were seen on both modalities, 6 only on CT, and 1 was indeterminate, while 8 had no obstruction, leading to the conclusion that CT is more accurate for stone detection but equally effective for obstruction assessment.

Abstract

PURPOSE: To compare non-contrast-enhanced computed tomography (CT) and intravenous urography (IVU) in the evaluation of patients who present with acute flank pain and in whom ureteric obstruction is suspected. MATERIALS AND METHODS: The findings at non-contrast-enhanced CT and IVU in 20 patients with acute flank pain were compared for the presence or absence of ureteric obstruction and delineation of ureteric stones. RESULTS: Twelve of the 20 patients had non-contrast-enhanced CT and IVU findings consistent with ureteric obstruction. Of these 12 patients, five had a ureteric stone that was demonstrated on both non-contrast-enhanced CT scans and IVU radiographs, six had a stone that was depicted on non-contrast-enhanced CT scans only, and in one patient a stone could not be delineated definitively on either non-contrast-enhanced CT scans or IVU radiographs. Eight patients had findings at non-contrast-enhanced CT and IVU consistent with the absence of obstruction. CONCLUSION: Non-contrast-enhanced CT is more effective than IVU in precisely identifying ureteric stones and is equally effective as IVU in the determination of the presence or absence of ureteric obstruction.