Value of 3-dimensional transrectal/transvaginal sonography in diagnosis of distal ureteral calculi.
OBJECTIVE
In a prospective study, the feasibility of 3-dimensional (3D) transrectal/transvaginal sonography in comparison with transabdominal sonography and intravenous urography (IVU) in identifying distal ureteral calculi was evaluated.


METHODS
Sixty-two patients in the urologic clinic with clinical suspicion of distal ureteral calculi were included. The patients consisted of 44 men and 18 women with a mean age +/- SD of 44 +/- 17 years. These patients underwent 3D transrectal/transvaginal sonography, transabdominal sonography with IVU, and, finally, ureterorenoscopy.


RESULTS
Fifty-nine patients were confirmed to have distal ureteral calculi on the basis of urologic intervention (ureterorenoscopy). Three patients had a spontaneous stone passage immediately after imaging completion. The median size of the calculi was 3.7 +/- 2.00 mm. Transabdominal sonography detected 34 of the 62 patients with calculi (sensitivity, 55%). The median size of the calculi was calculated as 5.0 +/- 2.4 mm. The examination time was 6.5 +/- 2.7 minutes. Intravenous urography detected 44 of the 62 patients with ureterolithiasis (sensitivity, 71%). Herein, the median stone size was measured as 3.9 +/- 1.9 mm, and the examination time was 38 +/- 17 minutes. The combination of transabdominal sonography and IVU in visualization of ureterolithiasis raised the sensitivity to 81% (50 of 62 patients). Three-dimensional transrectal/transvaginal sonography showed ureterolithiasis in all 62 patients confirmed to have distal ureteral calculi (sensitivity and specificity, 100%). The median size of the calculi was calculated as 4.4 +/- 2.2 mm, and the examination took 1.9 +/- 0.6 minutes.


CONCLUSIONS
The data in our prospective study show that transrectal/transvaginal sonography with 3D image assessment is superior to IVU and abdominal sonography for diagnosing distal ureteral calculi.
Mitterberger
Michael
M
Department of Urology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. michael.mitterberger@uibk.ac.at
Pinggera
Germar Michael
GM
Maier
Elisabeth
E
Neuwirt
Hannes
H
Neururer
Richard
R
Pallwein
Leo
L
Gradl
Johannes
J
Bartsch
Georg
G
Strasser
Hannes
H
Frauscher
Ferdinand
F
D000328:Adult; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007275:Injections, Intravenous; D008297:Male; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods; D014514:Ureteral Calculi / Q000000981:diagnostic imaging*; D014567:Urography / Q000379:methods
D003287:Contrast Media