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Urinary calculus: IVU vs. CT renal stone? A critically appraised topic

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Abstract

Background

We wondered whether noncontrast CT performs better than the intravenous urogram (IVU) in the detection of urinary calculi.

Methods

A comprehensive search of the literature was undertaken in order to answer the above question. Both primary and secondary sources of evidence were searched. The retrieved evidence was then appraised.

Results

The strongest evidence was in a meta-analysis by Worster and colleagues (level 1a evidence according to the Oxford/CEBM levels of evidence). This was an analysis of four studies with a total of 296 patients who underwent intravenous urogram and noncontrast CT. This study shows that CT has better diagnostic performance than IVU for the detection of urinary stones.

Conclusions

The literature suggests that CT should be utilized in preference to IVU for patients with suspected urolithiasis.

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References

  1. Staunton M (2007) Evidence-based radiology: steps 1 and 2—asking answerable questions and searching for evidence. Radiology 242(1):23–31

    PubMed  Google Scholar 

  2. Haynes RB (2001) Of studies, summaries, synopses, and systems: the “4S” evolution of services for finding current best evidence. Evid Based Ment Health 4(2):37–39

    Article  PubMed  CAS  Google Scholar 

  3. Up to date, http://www.uptodate.com, accessed on February 21, 2007

  4. Worster A, Preyra I, Weaver B, et al. (2002) The accuracy of noncontrast helical computed tomography versus intravenous pyelography in the diagnosis of suspected acute urolithiasis: a meta-analysis. Ann Emerg Med 40(3):280–286

    Article  PubMed  Google Scholar 

  5. Dalrymple NC, Verga M, Anderson KR, et al. (1998) The value of unenhanced helical computerized tomography in the management of acute flank pain. J Urol 159(3):735–740

    Article  PubMed  CAS  Google Scholar 

  6. Smith RC, Rosenfield AT, Choe KA, et al. (1995) Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography. Radiology 194(3):789–794

    PubMed  CAS  Google Scholar 

  7. Ha M, MacDonald RD (2004) Impact of CT scan in patients with first episode of suspected nephrolithiasis. J Emerg Med 27(3):225–231

    Article  PubMed  Google Scholar 

  8. Miller OF, Rineer SK, Reichard SR, et al. (1998) Prospective comparison of unenhanced spiral computed tomography and intravenous urogram in the evaluation of acute flank pain. Urology 52(6):982–987

    Article  PubMed  CAS  Google Scholar 

  9. Niall O, Russell J, MacGregor R, et al. (1999) A comparison of noncontrast computerized tomography with excretory urography in the assessment of acute flank pain. J Urol 161(2):534–537

    Article  PubMed  CAS  Google Scholar 

  10. Sourtzis S, Thibeau JF, Damry N, et al. (1999) Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography. AJR Am J Roentgenol 172(6):1491–1494

    PubMed  CAS  Google Scholar 

  11. Yilmaz S, Sindel T, Arslan G, et al. (1998) Renal colic: comparison of spiral CT, US and IVU in the detection of ureteral calculi. Eur Radiol 8(2):212–217

    Article  PubMed  CAS  Google Scholar 

  12. PUBMED online search engine. http://www.ncbi.nlm.nih.gov/entrez. Accessed on February 21, 2007

  13. Levels of evidence Oxford Centre for Evidence-Based Medicine Website. http://www.cebm.net/levels_of_evidence.asp. Accessed on May 5, 2007[t1]

  14. http://www.cche.net/usersguides/overview.asp. Accessed on May 5, 2007

  15. Halligan S, Altman DG (2007) Evidence-based practice in radiology: steps 3 and 4—appraise and apply systematic reviews and meta-analyses. Radiology 243(1):13–27

    PubMed  Google Scholar 

  16. Dodd JD (2007) Evidence-based practice in radiology: steps 3 and 4—appraise and apply diagnostic radiology literature. Radiology 242(2):342–354

    PubMed  Google Scholar 

  17. Dodd JD, MacEneaney PM, Malone DE (2004) Evidence-based radiology: how to quickly assess the validity, strength of publications in the diagnostic radiology literature. European radiology 14(5):915–922

    Article  PubMed  Google Scholar 

  18. Mackenzie R, Dixon AK (1995) Measuring the effects of imaging: an evaluative framework. Clin Radiol 50(8):513–518

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Many thanks to Dr. Dermot Malone, St Vincent’s University Hospital, Dublin 4, Ireland. S. Shine is a fourth year trainee in the program of the Faculty of Radiologists, Royal College of Surgeons in Ireland. EBP methods were learned during the University College Dublin MSc in Radiological Sciences course.

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Authors and Affiliations

  1. Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland

    Suzanne Shine

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  1. Suzanne Shine
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Correspondence to Suzanne Shine.

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Shine, S. Urinary calculus: IVU vs. CT renal stone? A critically appraised topic. Abdom Imaging 33, 41–43 (2008). https://doi.org/10.1007/s00261-007-9307-0

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  • DOI: https://doi.org/10.1007/s00261-007-9307-0

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