US Color Doppler Kidneys and Bladder Retroperitoneal There is no evidence to support the use of dedicated US color Doppler in the evaluation of pregnant patients with suspicion of stone disease. This procedure is intended for evaluation of vasculature. US Kidneys and Bladder Retroperitoneal US is frequently used as a screening examination, because US is a sensitive and specific test for diagnosing hydronephrosis and does not expose the patient or fetus to ionizing radiation [52-54]. Variant 4: Acute onset flank pain. Suspicion of stone disease. CT without contrast is inconclusive for the presence of stones. Next imaging study. In clinical practice, a no ncontract CT may b e inconclusive for stones when it is unclear whether an identified calcification is located within the ureter or an adjacent structure. Common mimics of ureteral stones in clude phleboliths or arterial calcifications. This uncertainty can be exacerbated in thin patients with a lack of sufficient fat planes separating the ureters from adjacent structures. Acute Onset Flank Pain-Suspicion of Stone Disease enhanced CT does also allow for the evaluation of other etiologies of flank pain [43]. In studies evaluating the use of CT abdomen and pelvis with IV contrast following a noncontrast CT, contrast-enhanced CT provided additional information or revealed a new diagnosis in 5% to 18% of cases, while ultimately changing clinical management in only 2% to 3% of cases [44,45]. CT Abdomen and Pelvis Without and With IV Contrast There is no relevant literature documenting the additional benefit of repeat noncontrast CT followed by CT abdomen and pelvis with IV contrast after an inconclusive CT without IV contrast in the evaluation of stones. CT Abdomen and Pelvis Without IV Contrast There is no relevant literature documenting the additional benefit of repeat noncontrast CT after an inconclusive CT without IV contrast in the evaluation of stones.
Acute Onset Flank Pain Suspicion of Stone Disease Urolithiasis . US Color Doppler Kidneys and Bladder Retroperitoneal There is no evidence to support the use of dedicated US color Doppler in the evaluation of pregnant patients with suspicion of stone disease. This procedure is intended for evaluation of vasculature. US Kidneys and Bladder Retroperitoneal US is frequently used as a screening examination, because US is a sensitive and specific test for diagnosing hydronephrosis and does not expose the patient or fetus to ionizing radiation [52-54]. Variant 4: Acute onset flank pain. Suspicion of stone disease. CT without contrast is inconclusive for the presence of stones. Next imaging study. In clinical practice, a no ncontract CT may b e inconclusive for stones when it is unclear whether an identified calcification is located within the ureter or an adjacent structure. Common mimics of ureteral stones in clude phleboliths or arterial calcifications. This uncertainty can be exacerbated in thin patients with a lack of sufficient fat planes separating the ureters from adjacent structures. Acute Onset Flank Pain-Suspicion of Stone Disease enhanced CT does also allow for the evaluation of other etiologies of flank pain [43]. In studies evaluating the use of CT abdomen and pelvis with IV contrast following a noncontrast CT, contrast-enhanced CT provided additional information or revealed a new diagnosis in 5% to 18% of cases, while ultimately changing clinical management in only 2% to 3% of cases [44,45]. CT Abdomen and Pelvis Without and With IV Contrast There is no relevant literature documenting the additional benefit of repeat noncontrast CT followed by CT abdomen and pelvis with IV contrast after an inconclusive CT without IV contrast in the evaluation of stones. CT Abdomen and Pelvis Without IV Contrast There is no relevant literature documenting the additional benefit of repeat noncontrast CT after an inconclusive CT without IV contrast in the evaluation of stones.