Prospective Comparison of Nonenhanced Helical Computerized Tomography and Doppler Ultrasonography for the Diagnosis of Renal Colic

Shokeir, Ahmed A.; Abdulmaaboud, Magdy

doi:10.1016/s0022-5347(05)66431-2

Cited by 59 publications

(33 citation statements)

References 12 publications

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“…In accordance with the findings of Shokeir [31] and other authors, we found no significant correlation between the RI and the level of ureteral obstruction, whereas de Toledo [36] reported that proximal obstructions were associated with higher RIs than distal obstructions.…”

Section: Discussionsupporting

confidence: 91%

“…Other authors have observed a relation between the RI and the magnitude of dilation [31,35]. In our cohort, the RI exhibited no significant correlation with the degree of dilation or with the duration of the colic.…”

Section: Discussioncontrasting

confidence: 80%

“…Data in the scientific literature confirm that this marker is more sensitive in the diagnosis of complete rather than partial obstructions [31,34,35]. de Toledo et al [36], for example, reported a sensitivity of 91.8% in patients with complete obstruction but only 48.1% in those with partial obstruction.…”

Section: Discussionmentioning

confidence: 93%

“…In the 1980s Platt [30] and Sauvain [33] reported that RIs > 0.70 were indicative of acute ureteral obstruction; since then, numerous studies conducted in animals and humans have confirmed this finding and attributed more or less high sensitivity and specificity to CDUS measurement of the RI [7,28,29,31,32].…”

Section: Discussionmentioning

confidence: 98%

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The renal resistive index as a predictor of acute hydronephrosis in patients with renal colic

Piazzese

Mazzeo

Galipo

et al. 2012

Journal of Ultrasound

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KEYWORDSRenal colic; Hydronephrosis; Renal color Doppler ultrasound; Renal resistive index.Abstract Introduction: The objective of this study was to determine whether the renal resistive index (RI) can predict hydronephrosis in patients with renal colic (RC) and whether or not its performance is time-dependent. Materials and methods: The study population was composed of 54 patients admitted for unilateral RC. At the time of the first observation (time point I, tpI), each patient underwent routine examinations, abdominal ultrasonography, and renal color Doppler ultrasound (CDUS) with measurement of the RI. The two imaging studies were repeated 6,12,18,24,36, and 48 h later (tpII, tpIII, tpIV, tpV, tpVI, tpVII). In addition, each patient underwent noncontrast urinary tract CT 48e60 h after admission. A mean renal RI of >0.70 (mRIþ) for the symptomatic kidney was considered indicative of obstruction. Patients were retrospectively divided into two groups: those who developed dilatation (group A) and those who did not (group B). Results: A mRIþ on CDUS predicted the onset of hydronephrosis with 100% sensitivity, 84% specificity, 92.6% accuracy, PPV and NPV of 87.9% and 100%, and diagnostic efficiency of 84%. In group A, mRIþ were always observed before onset of hydronephrosis in a timedependent manner. In group B, mRIþ were observed occasionally in 4/25 patients (16%) and all were recorded at tpII. In these cases, the RI had returned to normal by tpIII. Conclusions: In our RC patients, renal RI obtained with CDUS predicted the onset of acute dilatation with higher sensitivity, specificity, accuracy, and diagnostic efficiency than ultrasonography, and it can be used routinely in the emergency department to supplement ultrasound findings. Sommario Introduzione: Obiettivo di questo studio è stato verificare se l'Indice di Resistenza Renale (IR) possa essere considerato un parametro predittivo dell'insorgenza dell'idronefrosi (IN) in caso di colica renale (CR) monolaterale e se esso è tempo correlato. Materiali e metodi: Lo studio ha incluso 54 pazienti ricoverati per CR monolaterale. Al momento della prima osservazione (time point I) tutti i pazienti sono stati sottoposti a esami routinari, a Ecografia addome e a Eco color Doppler renale (ECD) bilaterale con misurazione dell'IR. Dopo 6 (tpII), 12 (tpIII), 18 (tpIV), 24 (tpV), 36 (tpVI) e 48 (tpVII) ore è stata ripetuta l'ecografia dell'apparato urinario e l'ECD con la misurazione bilaterale dell'IR. A 48e60 ore dal ricovero inoltre tutti i pazienti sono stati sottoposti a TC dell'apparato urinario senza mezzo di contrasto. Un valore medio di IR maggiore di 0,70 (mRIþ) a livello del rene sintomatico è stato considerato come suggestivo di ostruzione. I pazienti, in relazione allo sviluppo di IN, sono stati suddivisi a posteriori in gruppo A (dilatazione presente) e B (dilatazione assente). Risultati: L'ECD con il rilevamento dei valori mRIþ ha mostrato un significativo valore diagnostico relativamente all'insorgenza dell'IN con una sensibilità del 100%, specificità 84%, ...

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 98%

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The renal resistive index as a predictor of acute hydronephrosis in patients with renal colic

Piazzese

Mazzeo

Galipo

et al. 2012

Journal of Ultrasound

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“…Important factors include the local prevalence of stone disease, medical resources available, relative costs in a particular system, and the merits and limitations of each diagnostic modality (6). Although CT is the gold standard for diagnosis of renal colic, it is not available outside hospital facilities and is costly (7).…”

Section: Discussionmentioning

confidence: 99%

Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones

Abdel-Gawad¹,

Kadasne²,

Anjikar³

et al. 2014

Int. braz j urol.

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A systematic review and meta‐analysis of clinical signs, symptoms, and imaging findings in patients with suspected renal colic

et al. 2022

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Study Objective The objective of this study was to conduct a systematic review and meta‐analysis of the diagnostic accuracy of the clinical signs, symptoms, laboratory investigations, and imaging modalities commonly used in patients with clinically suspected renal colic. Methods We conducted this systematic review and meta‐analysis according to an a priori, registered protocol (PROSPERO CRD42017055153). A literature search was performed using MEDLINE and EMBASE from inception to July 2, 2020. We assessed the risk of bias using Quality Assessment of Diagnostic Accuracy Studies–2, calculated likelihood ratios (LRs), and applied a random‐effects model for meta‐analysis. Results Among 7641 references screened, 76 were included in the systematic review and 53 were included in the meta‐analyis. The overall pooled prevalence for ureteral stones was 63% (95% confidence interval [CI], 58%–67%). No individual demographic feature, symptom, or sign when present had an LR+ ≥2.0 for identifying ureterolithiasis. A (Sex, Timing and Origin of pain, race, presence or absence of Nausea, and Erythrocytes) STONE score ≥10 increased (sensitivity 0.49, specificity 0.91, LR 5.3 [95% CI, 4.1–6.7]) and a STONE score <6 reduced the likelihood of ureteral stones (sensitivity 0.94, specificity 0.43, LR 0.15 [95% CI, 0.10–0.22]). Standard‐dose (sensitivity 0.96, specificity 0.94, LR+ 16 [95% CI, 11–23], LR− 0.05 [95% CI, 0.03–0.07]) and low‐dose computed tomography (CT) scanning (sensitivity 0.93, specificity 0.94, LR+ 17 [95% CI, 8.8–31], LR− 0.08 [95% CI, 0.03–0.19]) were the most useful imaging techniques for identifying patients with or without ureteral stones. Conclusions Individual signs, symptoms, or the presence of microscopic hematuria do not substantially impact the likelihood of ureteral stones in patients with clinically suspected renal colic. The STONE score at high and low thresholds and a modified STONE score at a high threshold may sufficiently guide physicians’ decisions to obtain imaging. Low‐dose, non‐contrast CT imaging provides superior diagnostic accuracy compared with all other imaging index tests that are comparable with standard CT imaging. Limitations of the evidence include methodological shortcomings and considerable heterogeneity of the included studies.

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Prospective Comparison of Nonenhanced Helical Computerized Tomography and Doppler Ultrasonography for the Diagnosis of Renal Colic

Abstract: Nonenhanced helical CT and change in resistive index are sensitive and specific tests that can contribute significantly to the diagnosis of acute unilateral renal obstruction. They can replace IVP, particularly in situations in which it is undesirable.

Cited by 59 publications

References 12 publications

The renal resistive index as a predictor of acute hydronephrosis in patients with renal colic

The renal resistive index as a predictor of acute hydronephrosis in patients with renal colic

Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones

A systematic review and meta‐analysis of clinical signs, symptoms, and imaging findings in patients with suspected renal colic

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