Urinary calculus: IVU vs. CT renal stone? A critically appraised topic.

Background: We wondered whether noncontrast CT performs better than the intravenous urogram (IVU) in the detection of urinary calculi.

Methods: A comprehensive search of the literature was undertaken in order to answer the above question. Both primary and secondary sources of evidence were searched. The retrieved evidence was then appraised.

Results: The strongest evidence was in a meta-analysis by Worster and colleagues (level 1a evidence according to the Oxford/CEBM levels of evidence). This was an analysis of four studies with a total of 296 patients who underwent intravenous urogram and noncontrast CT. This study shows that CT has better diagnostic performance than IVU for the detection of urinary stones.

Conclusions: The literature suggests that CT should be utilized in preference to IVU for patients with suspected urolithiasis.