Urolithiasis in Patients with Acute Flank Pain: Comparison of Plain Abdominal Radiography to Unenhanced Spiral CT

多年來無對比增強螺旋CT已在美國成為評估急性腰痛患者的常用檢查。本研究主要是針對101名發生急性腰痛的患者以無對比增強螺旋CT作比較，重新評估KUB X光素片的價值和限制。本研究發現以X光素片和無對比增強螺旋CT偵查泌尿道結石的敏感度各為63%和98%，亦即大約有三分之的一的結石無法在X光素片中顯現。經由輸尿管擴大的次級病徵也可能在無對比增強CT中區別靜脈石和結石。本研究再度證實X光素片和無對比增強螺旋CT相比，它在評估急性腰痛方面的價值有所限制。當患者經過體檢和X光素片檢查之後無法獲得診斷，而患者又對IVP有禁忌或患者遲疑不願接受檢查時，無對比增強螺旋CT是值得考慮的評估方法。

關鍵字

急性腰痛；電腦斷層；無對比增強；螺旋型；放射線攝影；素片；泌尿道結石

並列摘要

The unenhanced spiral CT haw been used to evaluate patients with acute flank pain popularly in the United States for many years. We performed this study to reassess the value and limitation of the plain KUB film in comparison with the unenhanced spiral CT in 101 patients with acute flank pain. We obtained a sensitivity of 63% and 98% for diagnosing urinary stones by the plain abdominal radiography and the unenhanced spiral CT respectively. About one-third of the stones depicted by the unenhanced CT were not able to be demonstrated on the plain radiographs in our patients. In the presence of secondary signs of ureteric obstruction including rueteric dilatation, it is still possible to differentiate stones from phleboliths in pelvic cavity on the unenhanced CT. We confirm that the plain radiography is of less value in evaluation of patients with acute flank pain caused by urolithiasis in comparison with the unenhanced spiral CT. We recommend the unenhanced spiral CT as a method of choice to assess the patients with acute flank pain when the results of physical examination and plain KUB film are inconclusive or suspicions for urolithiasis, and when the IVP is contraindicated to the patient or the patient hesitate to receive such a study.

並列關鍵字

acute flank pain ； CT ； unenhanced ； spiral ； radiography ； plain ； urinary stone

國際替代計量

Urolithiasis in Patients with Acute Flank Pain: Comparison of Plain Abdominal Radiography to Unenhanced Spiral CT

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