| Limitations to ultrasound in the detection and measurement of urinary tract calculi. | |
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MedLine Citation:
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PMID: 20206970 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate differences in stone measurement using computed tomography (CT) and ultrasound (US). Axial unenhanced helical CT is the reference-standard imaging modality for the assessment of urinary tract calculi; however, US is also commonly used. Differences in stone measurement using these techniques are poorly described and contributors to measurement error remain unknown. METHODS: All patients at our institution undergoing both abdominal CT and renal US less than 1 month apart since June 2004 were reviewed. Solitary renal calculi were identified on both CT and US in all cases. RESULTS: We identified 71 calculi in 60 patients. Compared with CT, US overestimated stone size, an effect that was more pronounced with smaller calculi. The mean stone measurement on CT was 7.4 +/- 4.4 mm and on US it was 9.2 +/- 4.5 mm (P = .018). For stones </=5 mm, US measurements were a mean of 1.9 +/- 1.2 mm greater than CT (P <.001). US and CT measurements were discordant for 60% of stones </=5 mm. Discordance was associated with US measurement of skin-to-stone distance (P = .018), but not body mass index (P = .189) or location within the urinary tract (P = .161). Review of the literature revealed that US has a pooled sensitivity and specificity of 45% and 94%, respectively, for the detection of ureteric calculi and 45% and 88%, respectively, for renal calculi. CONCLUSIONS: US overestimates stone size in urolithiasis, a finding that may have implications for stone management. Discordance in stone measurement varies with size and is greatest in stones </=5 mm. US measurement of skin-stone-distance is an important determinant of error in US measurement of renal calculi. |
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Authors:
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A Andrew Ray; Daniela Ghiculete; Kenneth T Pace; R John D'A Honey |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-03-05 |
Journal Detail:
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Title: Urology Volume: 76 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-10 Completed Date: 2010-09-13 Revised Date: 2011-01-14 |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
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Languages: eng Pagination: 295-300 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Urology, St. Michael's Hospital, University of Toronto, Toronto, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Diagnostic Errors Female Humans Kidney Calculi / radiography*, ultrasonography* Male Middle Aged Retrospective Studies Tomography, X-Ray Computed* |
| Comments/Corrections | |
Comment In:
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Urology. 2011 Jan;77(1):258-9; author reply 259
[PMID:
21195853
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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