Sonographic detection of renal and ureteral stones: value of the twinkling sign

AUTOR(ES)

Mitterberger, Michael, Aigner, Friedrich, Pallwein, Leo, Pinggera, Germar-Michael, Neururer, Richard, Rehder, Peter, Frauscher, Ferdinand

FONTE

International braz j urol

DATA DE PUBLICAÇÃO

2009-10

RESUMO

Purpose: To compare the detection of urinary stones using standard gray scale ultrasound for diagnostic accuracy using the color Doppler "twinkling sign". Material and Methods: Our study population consisted of forty-one patients who demonstrated at least one urinary stone on unenhanced CT evaluation of the kidneys or ureters. Each patient was evaluated using gray scale ultrasound and color Doppler imaging by an observer who was blinded to the CT results. Results: Seventy-seven stones were present in 41 patients, including 47 intrarenal stones, 5 stones in the renal pelvis, 8 stones at the ureteropelvic junction, 5 ureteral stones and 12 stones at the ureterovesical junction. Based upon gray scale sonography the diagnosis of stone was made with confidence in 66% (51/77) of locations. Based upon Doppler sonography using the twinkling sign, the diagnosis of stone was made with confidence in 97% (75/77) of locations. Clustered ROC analysis demonstrated that the Doppler twinkling sign (Az = 0.99) was significantly better than conventional gray scale criteria (Az = 0.95) for the diagnosis of urinary stones (p = 0.005, two-sided test). Conclusions: The color Doppler twinkling sign improves the detection, confidence and overall accuracy of diagnosis for renal and ureteral stones with minimal loss of specificity.

Documentos Relacionados

• Treatment of renal lower pole stones: an update
• Shock Wave Lithotripsy in Ureteral Stones: Evaluation of Patient and Stone Related Predictive Factors
• Staghorn renal stones: what the urologist needs to know
• Retroperitoneoscopy for treatment of renal and ureteral stones
• Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones