Document Detail


Sonographic detection of renal and ureteral stones. Value of the twinkling sign.
MedLine Citation:
PMID:  19860931     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare the detection of urinary stones using standard gray scale ultrasound for diagnostic accuracy using the color Doppler "twinkling sign".
MATERIALS 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.
Authors:
Michael Mitterberger; Friedrich Aigner; Leo Pallwein; Germar-Michael Pinggera; Richard Neururer; Peter Rehder; Ferdinand Frauscher
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International braz j urol : official journal of the Brazilian Society of Urology     Volume:  35     ISSN:  1677-6119     ISO Abbreviation:  Int Braz J Urol     Publication Date:    2009 Sep-Oct
Date Detail:
Created Date:  2009-10-28     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158091     Medline TA:  Int Braz J Urol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  532-9; discussion 540-1     Citation Subset:  IM    
Affiliation:
Department of Urology, Medical University Innsbruck, Innsbruck, Austria. Michael.Mitterberger@i-med.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Contrast Media / diagnostic use
Female
Humans
Kidney Calculi / radiography,  ultrasonography*
Male
Middle Aged
ROC Curve
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed
Ultrasonography, Doppler, Color*
Ureteral Calculi / radiography,  ultrasonography*
Young Adult
Chemical
Reg. No./Substance:
0/Contrast Media

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