Non-Contrast MDCT For Ureteral Calculi and Alternative Diagnoses: Yield in Adult Women Versus in Adult Men

Publication date: Available online 2 February 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Parisa Fani, Michael N. Patlas, Sandra Monteiro, Douglas S. Katz
PurposeTo determine the yield of non-contrast Multi-Detector Computed Tomography (MDCT) of the abdomen and pelvis in diagnosing the ureteral calculus as well as other alternative acute conditions in male versus in female patients presenting to the emergency department with new onset symptoms.MethodsOur institutional review board approved a retrospective review of the official reports of the non-contrast MDCT examination of the abdomen and pelvis performed on adults (18 years and older) presenting to our emergency department with suspected ureteral calculus from October 1, 2011 to Oct 30, 2013. Patients with recently documented ureteral calculi, known urinary tract infection, malignancy and trauma were excluded from the study. From a total of 1097 non-contrast MDCT examinations of the abdomen and pelvis over the 2-year period, 400 randomly selected cases were reviewed (approximately one-third of all the examinations). We compared the prevalence of ureteral calculi between the male and female population. P value and confidence intervals were determined using software Stata 14. Other acute intra-abdominal findings amenable to prompt medical care were also documented and analyzed separately.ResultsThe mean age was 55.2 years, with a range of 19 to 90 years. This included 170 female (mean age 56.8 years) and 230 male patients (mean age 54.2 years). Ureteral calculi were detected in 170 (42.5%) of the patients [111 male (48%) and 59 female (34.7%)] with prevalence significantly higher in the male patients compared to in female patients (p<0.01, confidence level of 95% and CI of 13.2–13.4). Alternative diagnosis was made in 49 cases (12.25 %), including 26 females (15.29%) and 23 males (10.00%). There was no significant difference in alternative acute findings in male compared to in female patients (p > 0.05). This was with the exception of acute pyelonephritis, which was significantly higher in the female patients (p<0.01).ConclusionOur study determined that the likelihood of making the diagnosis of a ureteral calculus on non-contrast MDCT of the abdomen and pelvis was significantly higher in male patients compared with female patients presenting to our emergency department. However, there was no statistically significant difference in the alternative diagnoses, with the exception of pyelonephritis, which was more common in women.



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