TY - JOUR
T1 - Comparative analysis and interobserver variation of unenhanced computed tomography and intravenous urography in the diagnosis of acute flank pain
AU - Bennakhi, Abdelmohsen
AU - Gupta, Renu
AU - Al-Hunayan, Adel
AU - Muttikkal, Thomas
AU - Chavan, Venu
AU - Mohammed, Ahmed
AU - Ali, Yusuf
PY - 2010/2/1
Y1 - 2010/2/1
N2 - Objectives: The purpose of this study was to compare unenhanced computed tomography (UECT) to intravenous urography (IVU) for detecting urinary tract calculi, signs of obstruction and non-renal causes in the assessment of acute flank pain, and in their interobserver agreement. Patients and Methods: In this prospective study, carried out at a university hospital over a period of 1 year, 36 patients (27 males and 9 females) participated. Mean age was 44 ± 15 years (range: 14-73 years). The patients presented with acute flank pain and underwent UECT and IVU. The images were blindly evaluated by 2 experienced radiologists and the two techniques compared using the two-tailed McNemar's test for matched pairs; p values <0.05 were considered significant. Results: UECT detected stones in 11 (30.6%) patients, while IVU found them in only 8 (22.2%). The increased detection by UECT was due to its ability to detect smaller stones (<6 mm). UECT was also found to be better than IVU in determining calculus position, in detecting primary or secondary signs of obstruction and in identifying non-urinary causes of flank pain. The overall average of agreement, as indicated by kappa values, was 0.88 for UECT and 0.61 for IVU. Conclusion: UECT showed better detectability and interobserver agreement tan IVU, suggesting that UECT could replace IVU as the first imaging modality in the evaluation of acute renal colic.
AB - Objectives: The purpose of this study was to compare unenhanced computed tomography (UECT) to intravenous urography (IVU) for detecting urinary tract calculi, signs of obstruction and non-renal causes in the assessment of acute flank pain, and in their interobserver agreement. Patients and Methods: In this prospective study, carried out at a university hospital over a period of 1 year, 36 patients (27 males and 9 females) participated. Mean age was 44 ± 15 years (range: 14-73 years). The patients presented with acute flank pain and underwent UECT and IVU. The images were blindly evaluated by 2 experienced radiologists and the two techniques compared using the two-tailed McNemar's test for matched pairs; p values <0.05 were considered significant. Results: UECT detected stones in 11 (30.6%) patients, while IVU found them in only 8 (22.2%). The increased detection by UECT was due to its ability to detect smaller stones (<6 mm). UECT was also found to be better than IVU in determining calculus position, in detecting primary or secondary signs of obstruction and in identifying non-urinary causes of flank pain. The overall average of agreement, as indicated by kappa values, was 0.88 for UECT and 0.61 for IVU. Conclusion: UECT showed better detectability and interobserver agreement tan IVU, suggesting that UECT could replace IVU as the first imaging modality in the evaluation of acute renal colic.
KW - Acute flank pain
KW - Interobserver agreement
KW - Intravenous urography
KW - Unenhanced computed tomography
UR - http://www.scopus.com/inward/record.url?scp=76949093504&partnerID=8YFLogxK
U2 - 10.1159/000273072
DO - 10.1159/000273072
M3 - Article
C2 - 20134174
AN - SCOPUS:76949093504
VL - 19
SP - 118
EP - 121
JO - Medical Principles and Practice
JF - Medical Principles and Practice
SN - 1011-7571
IS - 2
ER -