spiral CT scan in renal colic

Last reviewed 01/2018

• noncontrast Helical (spiral) CT
  • being used increasingly in the initial assessment of renal colic
  • fast and accurate, and it readily identifies all stone types in all locations
    • sensitivity (95 to 100 percent) and specificity (94 to 96 percent) suggest that it may definitively exclude stones in patients with abdominal pain
  • associated features of renal colic such as renal enlargement, perinephric or periureteral inflammation or "stranding," and distension of the collecting system or ureter, are sensitive indicators of the degree of ureteral obstruction
  • density of calculi may be used to distinguish cystine and uric acid stones from calcium-bearing stones and is capable of further subtyping the calcium stones into calcium phosphate, calcium oxalate monohydrate and calcium oxalate dihydrate stones
  • useful in diagnosing nonurologic causes of abdominal pain, such as abdominal aortic aneurysms and cholelithiasis
  • may allow intravenous pyelography to be reserved for therapeutic planning in complex stone cases
    

Reference:

• 1. Portis AJ, Sundaram , CP.Diagnosis and Initial Management of Kidney Stones. American Family Physician 2001.
• 2. Mostafavi MR et al. Accurate determination of chemical composition of urinary calculi by spiral computerized tomography. J Urol 1998;159:673-5.