The effectiveness and accuracy of ultrasound in the diagnosis of nephrolithiasis and measurement of kidney stone size
Abstract
Aim: To demonstrate the accuracy of ultrasonography (US) in diagnosing nephrolithiasis and measuring stone size.
Materials and Methods: Overall, 193 patients who underwent a urinary system US examination and had a non-contrast computed tomography (CT) examination within one month were retrospectively reviewed. US reports and CT images were evaluated regarding the presence and size of stones, their localization, and accompanying hydronephrosis, and the stone sizes were compared.
Results: In 193 patients included in the study, 318 stones were detected by US or CT. Overall, 57.7% of stones identified by CT were detected using US. The stone sizes measured were compared for 183 (57.5%) stones detected by both US and CT in 141 (73.0%) patients. The mean stone size was 8.78±6.79 mm in US and 8.11±6.72 mm in CT (p<0.001). The mean stone sizes measured by US were higher than those measured by CT in all size groups (≤5 mm, >5–10 mm, >10 mm; p<0.001) and all localizations (p<0.05). In both groups with and without hydronephrosis, the stone size measured by US was higher than that measured by CT (p<0.001). In 15% of the patients, the stone size measured by US was greater than 5mm, considered clinically significant, while on the CT, these stones were smaller than 5mm.
Conclusion: US is less sensitive than CT in diagnosing nephrolithiasis, and when stones are assessed per size, location, and the presence of hydronephrosis, the stone sizes measured using US were found to be larger than those measured using CT in all groups.
References
- Nadeem M, Ather MH, Jamshaid A, Zaigham S, Mirza R, Salam B. Rationale use of unenhanced multi-detector CT (CT KUB) in evaluation of suspected renal colic. Int J Surg. 2012;10(10):634–7.
- Smith-Bindman R, Aubin C, Bailitz J, Bengiamin RN, Camargo CA, Corbo J, et al. Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med. 2014;371(12):1100–10.
- Vijayakumar M, Ganpule A, Singh A, Sabnis R, Desai M. Review of techniques for ultrasonic determination of kidney stone size. Res Rep Urol. 2018;10:57–61.
- Coll DM, Varanelli MJ, Smith RC. Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT. AJR Am J Roentgenol. 2002;178(1):101–3.
- Fowler KAB, Locken JA, Duchesne JH, Williamson MR. US for detecting renal calculi with nonenhanced CT as a reference standard. Radiology. 2002;222(1):109–13.
- Ray AA, Ghiculete D, Pace KT, Honey RJD. Limitations to ultrasound in the detection and measurement of urinary tract calculi. Urology. 2010;76(2):295–300.
- Kanno T, Kubota M, Sakamoto H, Nishiyama R, Okada T, Higashi Y, et al. The efficacy of ultrasonography for the detection of renal stone. Urology. 2014;84(2):285–8.
- Dunmire B, Lee FC, Hsi RS, Cunitz BW, Paun M, Bailey MR, et al. Tools to improve the accuracy of kidney stone sizing with ultrasound. J Endourol. 2015;29(2):147–52.
- Sternberg KM, Eisner B, Larson T, Hernandez N, Han J, Pais VM. Ultrasonography Significantly Overestimates Stone Size When Compared to Low-dose, Noncontrast Computed Tomography. Urology. 2016;95:67–71.
- Ganesan V, De S, Greene D, Torricelli FCM, Monga M. Accuracy of ultrasonography for renal stone detection and size determination: is it good enough for management decisions? BJU Int. 2017;119(3):464–9.
- Ahmed F, Askarpour MR, Eslahi A, Nikbakht HA, Jafari SH, Hassanpour A, et al. The role of ultrasonography in detecting urinary tract calculi compared to CT scan. Res Rep Urol. 2018;10:199–203.
- Alahmadi AE, Aljuhani FM, Alshoabi SA, Aloufi KM, Alsharif WM, Alamri AM. The gap between ultrasonography and computed tomography in measuring the size of urinary calculi. J Family Med Prim Care. 2020;9(9):4925–8.
- Chiou T, Meagher MF, Berger JH, Chen TT, Sur RL, Bechis SK. Software-Estimated Stone Volume Is Better Predictor of Spontaneous Passage for Acute Nephrolithiasis. J Endourol. 2023;37(1):85–92.
- Schlunk S, Hsi R, Byram B. Enhancing sizing accuracy in ultrasound images with an alternative ADMIRE model and dynamic range considerations. Ultrasonics. 2023;131:106952.
- Abbas SK, Al-Omary TSS, Fawzi HA. Ultrasound accuracy in evaluating renal calculi in Maysan province. J Med Life. 2024;17(2):226–32.
- Eisner BH, Kambadakone A, Monga M, Anderson JK, Thoreson AA, Lee H, et al. Computerized tomography magnified bone windows are superior to standard soft tissue windows for accurate measurement of stone size: an in vitro and clinical study. J Urol. 2009;181(4):1710–5.
- Ripollés T, Errando J, Agramunt M, Martínez MJ. Ureteral colic: US versus CT. Abdom Imaging. 2004;29(2):263–6.
- Dunmire B, Harper JD, Cunitz BW, Lee FC, Hsi R, Liu Z, et al. Use of the Acoustic Shadow Width to Determine Kidney Stone Size with Ultrasound. J Urol. 2016;195(1):171–7.
Abstract
Amaç: Ultrasonografinin (US) nefrolitiazis tanısında ve böbrek taşı boyut ölçümündeki doğruluğunun ortaya konulması amaçlanmıştır.
Gereç ve Yöntem: Üriner sistem US tetkiki yapılan ve 1 ay içerisinde kontrastsız bilgisayarlı tomografi (BT) tetkiki de mevcut olan 193 hastanın, US raporları ve BT görüntüleri retrospektif olarak incelenerek üriner sistemde taş varlığı ve boyutu, lokalizasyonu ve eşlik eden hidronefroz varlığı yönünden değerlendirilip taş boyutları karşılaştırıldı.
Bulgular: Çalışmaya dahil edilen 193 hastada, US veya BT ile 318 adet taş tespit edildi. BT ile saptanan taşların %57,7’si US ile saptanabildi.
Taş boyut ölçümü için karşılaştırma 141 (%73,0) hastada, hem US hem de BT’de saptanan 183 (%57,5) taş için yapıldı. Taşların boyut ortalaması US ve BT’de sırasıyla 8,78±6,79 mm ve 8,11±6,72 mm olarak ölçüldü (p<0,001). Taşlar boyutlarına göre (≤5 mm, >5–10 mm, >10 mm) ayrıldığında tüm gruplarda US ile ölçülen ortalama taş boyutları BT’ye kıyasla daha büyüktü (p<0,001). Tüm lokalizasyonlarda US ile ölçülen taş boyutu BT’ye göre daha büyük saptandı (p<0,05). Hidronefrozu olan ve olmayan her iki grupta da taş boyutu US’de, BT’den daha büyük ölçüldü (p<0,001). Hastaların %15’inde US’de taş boyutu klinik olarak anlamlı kabul edilen 5mm’den büyük ölçülürken; BT’de bu taşların 5mm’den küçük olduğu anlaşıldı.
Sonuç: US’nin nefrolitiazis tanısında duyarlılığı BT’ye kıyasla daha düşük olup, boyut, yerleşim ve hidronefroz varlığına göre taşlar incelendiğinde tüm gruplarda US ile ölçülen taş boyutları BT’ye kıyasla daha büyük olarak saptandı.
References
- Nadeem M, Ather MH, Jamshaid A, Zaigham S, Mirza R, Salam B. Rationale use of unenhanced multi-detector CT (CT KUB) in evaluation of suspected renal colic. Int J Surg. 2012;10(10):634–7.
- Smith-Bindman R, Aubin C, Bailitz J, Bengiamin RN, Camargo CA, Corbo J, et al. Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med. 2014;371(12):1100–10.
- Vijayakumar M, Ganpule A, Singh A, Sabnis R, Desai M. Review of techniques for ultrasonic determination of kidney stone size. Res Rep Urol. 2018;10:57–61.
- Coll DM, Varanelli MJ, Smith RC. Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT. AJR Am J Roentgenol. 2002;178(1):101–3.
- Fowler KAB, Locken JA, Duchesne JH, Williamson MR. US for detecting renal calculi with nonenhanced CT as a reference standard. Radiology. 2002;222(1):109–13.
- Ray AA, Ghiculete D, Pace KT, Honey RJD. Limitations to ultrasound in the detection and measurement of urinary tract calculi. Urology. 2010;76(2):295–300.
- Kanno T, Kubota M, Sakamoto H, Nishiyama R, Okada T, Higashi Y, et al. The efficacy of ultrasonography for the detection of renal stone. Urology. 2014;84(2):285–8.
- Dunmire B, Lee FC, Hsi RS, Cunitz BW, Paun M, Bailey MR, et al. Tools to improve the accuracy of kidney stone sizing with ultrasound. J Endourol. 2015;29(2):147–52.
- Sternberg KM, Eisner B, Larson T, Hernandez N, Han J, Pais VM. Ultrasonography Significantly Overestimates Stone Size When Compared to Low-dose, Noncontrast Computed Tomography. Urology. 2016;95:67–71.
- Ganesan V, De S, Greene D, Torricelli FCM, Monga M. Accuracy of ultrasonography for renal stone detection and size determination: is it good enough for management decisions? BJU Int. 2017;119(3):464–9.
- Ahmed F, Askarpour MR, Eslahi A, Nikbakht HA, Jafari SH, Hassanpour A, et al. The role of ultrasonography in detecting urinary tract calculi compared to CT scan. Res Rep Urol. 2018;10:199–203.
- Alahmadi AE, Aljuhani FM, Alshoabi SA, Aloufi KM, Alsharif WM, Alamri AM. The gap between ultrasonography and computed tomography in measuring the size of urinary calculi. J Family Med Prim Care. 2020;9(9):4925–8.
- Chiou T, Meagher MF, Berger JH, Chen TT, Sur RL, Bechis SK. Software-Estimated Stone Volume Is Better Predictor of Spontaneous Passage for Acute Nephrolithiasis. J Endourol. 2023;37(1):85–92.
- Schlunk S, Hsi R, Byram B. Enhancing sizing accuracy in ultrasound images with an alternative ADMIRE model and dynamic range considerations. Ultrasonics. 2023;131:106952.
- Abbas SK, Al-Omary TSS, Fawzi HA. Ultrasound accuracy in evaluating renal calculi in Maysan province. J Med Life. 2024;17(2):226–32.
- Eisner BH, Kambadakone A, Monga M, Anderson JK, Thoreson AA, Lee H, et al. Computerized tomography magnified bone windows are superior to standard soft tissue windows for accurate measurement of stone size: an in vitro and clinical study. J Urol. 2009;181(4):1710–5.
- Ripollés T, Errando J, Agramunt M, Martínez MJ. Ureteral colic: US versus CT. Abdom Imaging. 2004;29(2):263–6.
- Dunmire B, Harper JD, Cunitz BW, Lee FC, Hsi R, Liu Z, et al. Use of the Acoustic Shadow Width to Determine Kidney Stone Size with Ultrasound. J Urol. 2016;195(1):171–7.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Medical Education |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | June 10, 2025 |
| Submission Date | December 31, 2024 |
| Acceptance Date | April 18, 2025 |
| Published in Issue | Year 2025 Volume: 64 Issue: 2 |
