JOURNAL ARTICLE

Urolithiasis: how accurate are plain radiographs?

V O Chan, O Buckley, T Persaud, W C Torreggiani
Canadian Association of Radiologists Journal 2008, 59 (3): 131-4
18697719

OBJECTIVE: To determine the value of the kidneys, ureters, and bladder radiograph (KUB) in the diagnosis of urolithiasis using unenhanced helical computerized tomography (UHCT) as the gold standard.

METHODS: A retrospective study was performed on 100 consecutive patients being investigated for suspected urolithiasis. All patients presented with acute renal colic and had a KUB and UHCT within a 3-hour period. UHCT and KUB pairs were assessed separately by 2 radiologists in consensus who were blinded to the clinical details of the patients and the results of the other tests and examinations. The presence, location, number, and size of stones were recorded. Each UHCT and KUB pair was then compared for concordance on a stone-by-stone basis.

RESULTS: KUB was concordant with the gold standard UHCT in only 50% of patients (11 positive, 39 negative), giving a sensitivity of 18.6%, a specificity of 95.1%, a positive predictive value of 84.6%, and a negative predictive value of 44.8%.

CONCLUSION: KUB has a very low sensitivity for the detection of urolithiasis, although specificity is acceptable.

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