Accuracy of Sonography in the Diagnosis of Urinary Tract Calculi Compared with Non-Contrast CT Scan

Document Type : Original Article

Authors

1 Department of Radiology, Faculty of Medicine, University of Medical Sciences, Ahvaz, Iran.

2 Department of Urology, School of Medicine, University of Medical Sciences, Ahvaz, Iran.

3 Department of Radiology, Faculty of Medicine, University of Medical Sciences, Ahvaz, Iran

4 Continuing Education Center, Institute of Toxicology, University of Medical Sciences, Ahvaz, Iran

Abstract

Background and Objective: This study was designed to determine sensitivity, specificity, PPV (positive predictive value), NPV (negative predictive value) and accuracy of sonography in comparison to non-contrast CT scan for diagnosis of urinary tract calculi.
Subjects and Methods: Total 131 patients with urinary calculi detected by noncontrast CT scan underwent sonography on the same day without bowel preparation and in blinded fashion from Sep 2011 to March 2012. CT scan and sonography findings including location and size of stones were gathered.
Results: The sensitivity, specificity, PPV, NPV and accuracy of sonography in detection of caliceal calculi were 91.7%, 72.9%, 80.5%, 87.8% and 83.2 %, respectively. The sensitivity, specificity, PPV, NPV and accuracy of sonography in detection of renal pelvis calculi were 85.7, 100, 100, 97.3 and 97.7 %, respectively. The sensitivity, specificity, PPV, NPV and accuracy of sonography in detection of ureter calculi were 53%, 93.8%, 89.7%, 66.3% and 73.3 %, respectively. The sensitivity, specificity, PPV, NPV and accuracy of sonography in detection of bladder calculi were 84.6%, 100%, 100%, 98.3% and 98.5 %, respectively. The sensitivity, specificity, PPV, NPV and accuracy of sonography in comparison to CT scan, for detection of all urinary tract calculi were 78.7%, 91.7%, 91.9%, 87.4%  and 88.2 % respectively.
Conclusion: Sonography is a reliable method in detection and confirmation of renal pelvis and bladder stones but is not reliable for detection of ureter and caliceal stones. Overall results show that sonography is the safe and first method for detection of renal calculi. However multislice CT scan remains second choice if sonography results are not sufficiently clear in patients with clinical doubt of ureter and caliceal of <3mm stones

Keywords

References

1-Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh urology. 10th ed. Philadelphia: Elsevier/Saunders; 2012.
2-Brant WE, Helms CA, eds. Fundamentals of diagnostic radiology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 889-90.
3-Fowler KA, Locken JA, Duchesne JH, Williamson MR. US for detecting renal calculi with nonenhanced CT as reference standard. Radiology 2002;222(1):109-13.
4-Passerotti C, Chow JS, Silva A, Schoettler CL, Rosoklija I, Perez-Rossello J, et al. Ultrasound versus computerized tomography for evaluating urolithiasis. J Urol 2009;182(4suppl):1829-34. 
5-King W 3rd, Kimme-Smith C, Winter J. Renal Stone shadowing: an investigation of                                                                                                                         contributing factors. Radiology 1985;154(1):191-6.
6-Sheafor DH, Hertzberg BS, Freed KS, Carroll BA, Keogan MT, Paulson EK, et al.  Nonenhanced helical CT and US in the emergency evaluation patients with renal colic: prospective comparison. Radiology 2000;217(3):792-7. 
7-Patlas M, Farkas A, Fisher D, Zaghal I, Hadas-Halpern I.  Ultrasound vs. CT for the detection of ureteric stones in patients with renal colic. Br J Radiol 2001;74(886):901-4.
8-Johnson CM, Wilson DM, O’Fallon WM, Malek RS, Kurland LT. Renal stone epidemiology: a 25-year study in Rochester, Minnesota.  Kidney Int 1979;16(5):624-31.
9-Hiatt RA, Dales LG, Friedman GD, Hunkeler EM. Frequency of urolithiasis in prepaid medical care program. Am J Epidemiol 1982;115(2):255-65.
10-Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC.  Time trends in reported prevalence of kidney stones in the United States: 1976-1994.  Kidney Int 2003;63(5):1817-23.
11-Moesbergen TC, De Ryke RJ, Dunbar S, Wells JE, Anderson NG.  Distal ureteral calculi: US follow up. Radiology 2011;260:575-80.
12-Middleton WD, Dodds WJ, Lawson TL, Foley WD.  Renal calculi: sensitivity with detection with US. Radiology 1988;167(1):239-44.
13-Vrtiska TJ, Hattery RR, King BF, Charboneau JW, Smith LH, Williamson B Jr, et al.  Role of ultrasound in medical management of patients with renal stone disease. Urol Radiol 1992;14(3):131-8.
14-Motola JA, Smith AD. Therapeutic options for the management of upper tract calculi. Urol Clin North Am 1990;17(1):191-206.
Jundishapur Scientific Medical Journal
Volume 12, Issue 2 - Serial Number 83
July and August 2013
Pages 209-215

Files

History

  • Receive Date: 05 August 2012
  • Revise Date: 07 October 2012
  • Accept Date: 18 February 2013

Share

How to cite

Statistics