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The value of unenhanced helical computed tomography in the evaluation of patients with pain in the flank.

Our purpose was to evaluate the accuracy of unenhanced helical computed tomography in the diagnosis of ureteral lithiasis, to establish the frequency of the main computed tomography findings, and to assess and compare the interobserver agreement with the results of conventional intravenous urography. A prospective double-blind study was carried out in 25 patients referred for unenhanced helical computed tomography and conventional intravenous urography due to nephretic colic. Both methods were employed to evaluate the size of the kidneys, hydronephrosis and the size and location of ureteral stones. Perirenal hyperdensities, periureteral edema and the halo sign were also assessed by unenhanced helical computed tomography. In 23 of the 25 unenhanced helical computed tomography examinations (92%) and in 17 of the 25 conventional intravenous urography examinations (68%) there was agreement on the results of the two observers. In 21 of the 25 patients, there was agreement between the results of both methods. We concluded that unenhanced helical computed tomography is as efficient as conventional intravenous urography in the evaluation of patients with nephretic colic, is a reproducible method, and avoids the discomfort of the use of intravenous contrast.

Lithiasis; Ureter; Kidney; Computed tomography


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