Present Role of Gray Scale Ultrasound Combined with Doppler in the Evaluation of Ureteric Calculi: Correlation with CT-Scan

Abstract

Introduction: One of the commonest causes for acute flank pain is ureteric calculi. Presently imaging modalities available in the evaluation of ureteric calculi include plain radiography, ultrasound, intravenous urography, noncontrast computed tomography and CT urography. In this study we evaluated the role of ultrasonography with respect to CT-scan for detection of ureteric calculi. Aim: To evaluate the role of gray scale ultrasound combined with Doppler in the diagnosis of ureteric calculi and to compare it with CT-scan. Materials and Methods: This was a prospective study and 80 patients with ureteric calculi who underwent CT-Kidney, Ureter, Bladder (KUB) examinations wererandomly selected for ultrasound examination. The results of ultrasonography were correlated with the findings on CT-scan and the sensitivity, specificity of ultrasonography when compared with CT-scan was evaluated. Results: Total 80 cases of ureteric calculi detected by CT. Ultrasound could detect 74 cases and rest 6 of the cases showed only indirect signs of obstruction like hydroureteronephrosis. The overall sensitivity, specificity, positive predictive value and negative predictive value for detection of ureteric calculi by ultrasounds were found to be 92.5 %, 100 %, 100% and 93% respectively. Conclusion: Ultrasound combined with Doppler is an effective, cost-effective method for diagnosing ureteric calculi and thereby reduces the number of patients subjected to CT examination.

Keywords

• acute obstruction
• flank pain
• twinkling artifact
• ureteric jet