Acute ureteric calculus obstruction: unenhanced spiral CT versus HASTE MR urography and abdominal radiograph
- 1 June 2005
- journal article
- research article
- Published by Oxford University Press (OUP) in The British Journal of Radiology
- Vol. 78 (930), 506-511
- https://doi.org/10.1259/bjr/22314006
Abstract
The aim of this study is to compare the performance of unenhanced spiral CT to the combination of HASTE MR urography (MRU) and plain abdominal radiography (KUB) in patients suspected of having acute calculus ureteric obstruction. 64 patients with suspected acute calculus ureteric obstruction were evaluated. The presence of perirenal fluid, presence and level of ureteric obstruction and calculi were assessed on both techniques. 44 of 64 (69%) patients had acute calculus ureteric obstruction based on clinical, radiographic or surgical findings. MRU showed perirenal fluid in acute ureteric obstruction (77%) with a greater sensitivity than CT showed stranding (45%). The combination of fluid and ureteric dilation on MRU showed a sensitivity of 93% (CT 80%), specificity of 95% (CT 85%), and accuracy of 94% (CT 81%). There were 61 findings of either fluid or ureteric dilatation on MRU in 44 acutely obstructed kidneys compared with 37 similar findings on CT (p0.75) in the finding of perirenal fluid on MRU, there was only fair interobserver agreement (Kappa<0.4) regarding perirenal stranding on CT. MRU/KUB showed ureteric calculi in 21/29 (72%) of patients with calculi seen by CT. Overall, MRU/KUB revealed 2.4 abnormalities per acutely obstructed ureter compared with 1.8 abnormalities detected by CT. MRU/KUB using HASTE sequences can diagnose the presence of acute calculus ureteric obstruction with similar accuracy to spiral CT. The technique has less observer variability and is more accurate than CT in detecting evidence of obstruction such as perirenal fluid.Keywords
This publication has 7 references indexed in Scilit:
- Unenhanced helical CT criteria to differentiate distal ureteral calculi from pelvic phleboliths.Radiology, 1998
- Unenhanced helical CT of ureterolithiasis: value of the tissue rim sign.American Journal of Roentgenology, 1997
- Soft-tissue "rim" sign in the diagnosis of ureteral calculi with use of unenhanced helical CT.Radiology, 1997
- MR urography using HASTE imaging in the assessment of ureteric obstruction.American Journal of Roentgenology, 1996
- Acute ureteral obstruction: value of secondary signs of helical unenhanced CT.American Journal of Roentgenology, 1996
- Breath-hold MR urography using the HASTE technique.American Journal of Roentgenology, 1996
- Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography.Radiology, 1995