title: The usefulness of ultrasound colour-Doppler twinkling artefact for detecting urolithiasis compared with low dose nonenhanced computerized tomography.
abstract: This prospective study evaluates the usefulness of the twinkling artefact (TA) seen on colour-Doppler ultrasound (US) in diagnosing urolithiasis. US and standard computed tomography (CT) were performed blinded on 105 patients. B-mode US and colour-Doppler used separately and in combination showed 55% sensitivity and 99% specificity (positive predictive value [PPV] 67% and negative predictive value [NPV] 98%). Of CT verified stones, 61% were ≤3 mm. TAs were present in 74% of the B-mode stones (43% of all CT verified stones). Patients with CT verified stone disease had significantly more TAs in other foci than the stone(s) found on CT, suggestive of microlithiasis. In conclusion, colour-Doppler TA is a helpful supplement for detecting urolithiasis when CT is contraindicated. In addition, US can be valuable in monitoring stones left to pass without intervention if they have presented a TA. CT, US and US with colour-Doppler TA can be useful as complementary techniques for detecting stones.
authors.affiliation: Department of Radiology Frederikssund, Hillerød Hospital, Hillerød, Denmark. rikkerass@dadlnet.dk
authors.forename: Rikke Rass
authors.initials: RR
authors.lastname: Winkel
authors.forename: Anna
authors.initials: A
authors.lastname: Kalhauge
authors.forename: Knud-Erik
authors.initials: KE
authors.lastname: Fredfeldt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D052878:Urolithiasis / Q000175:diagnosis*
chemical_list: D003287:Contrast Media