Comparison Study of USG with CT in Identifying Ureteric Calculi In Acute Ureteric Colic
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 12
Abstract
Aim:To assessing sensitivity, specificity, positive predictive value and negative value of Ultrasound (US) over Computerized Tomography (CT) in diagnosis ureteric calculi in patients with ureteric colic. Methods:A descriptive study involving 101 patients with acute ureteric colic referred to the Radiology department in Sree Balaji Medical College and Hospital, for US and CT imaging evaluation. Patients in the age groups of 20 – 70 years and of both men and women referred from emergency department for radiological evaluation of low backache were included. Pregnant women are excluded. USG was performed for all the patients following which proceeded with CT imaging. CT imaging of Kidney, ureter and Bladder. CT images are acquired in supine position and thin sections of ~ 2.5mm in axial plane following which reconstructed in coronal and sagittal planes. Results:Of 101 patients included in this study calculus was found in 63 patients by USG and in 79 patients by CT. This shows about 16 (20%) patients with calculi were missed on USG. On comparison of location of calculus by USG and CT we find that majority of the calculi missed by USG were located in the distal ureter and were in females, but in females ~ 50 % of mid ureteric calculi were missed by USG. Conclusion: USG is freely available, rapid and easy to perform and also absence of radiation hazard make it a safe and effective technique for screening of patients with suspected renal colic. Major drawback is it has poor sensitivity for detecting mid ureteric calculi, because the area is obscured by the bowel gas. CT has high sensitivity and specificity for detecting urolithiasis, Unenhanced CT is a valuable technique for examining patients with acute flank pain in whom a clinical diagnosis is uncertain. It can accurately determine the presence or absence of ureteral stones as well as extra urinary causes of acute flank pain.
Authors and Affiliations
Dr. Buvaneswari Shanmuganathan, Dr. M. Prabakaran, Dr. E. Prem Gowtham, Dr. M. S. Hemhnath
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