title: US detection of renal and ureteral calculi in patients with suspected renal colic.
abstract: OBJECTIVE
  The purpose of this study was to determine whether the color Doppler twinkling sign could be considered as an additional diagnostic feature of small renal lithiasis (_5mm).
  
  
  METHODS
  181 patients underwent CT scans performed for other pathologies; the images were also analyzed by a radiologists to identify the incidental presence of renal lithiasis equal to or smaller than 5 mm.These patients underwent an abdominal ultrasound examination, including grayscale analysis of the kidneys and color Doppler. Lithiasis were divided into three groups, on the basis of the diagnostic agreement provided by CT and gray scale results. Then, the twinkling sign sensitivity was assessed in the three groups.
  
  
  RESULTS
  The twinkling sign was positive in 177 out of 206 lithiasis (86 %) visible on CT, while the grayscale was absolutely positive in 98 out of 206 lithiasis (47.6%) and doubtful positive in 71 out of 206 lithiasis (31%).The twinkling sign was positive in 100% of absolutely positive and doubtful positive lithiasis on bmode, and in 8 out of 31 lithiasis not visible on b-mode.
  
  
  CONCLUSIONS
  In the diagnosis of small renal lithiasis, integrating gray-scale with color Doppler may be the most suitable procedure, because the color-Doppler twinkling sign is able to confirm the doubtful diagnosis of renal lithiasis and to detect some lithiasis that are not visible on b-mode.
authors.affiliation: Department of Health Science, University of Molise, Campobasso, Italy. lucabrunese@libero.it.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Vallone
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Napolitano
authors.forename: Paolo
authors.initials: P
authors.lastname: Fonio
authors.forename: Gabriele
authors.initials: G
authors.lastname: Antinolfi
authors.forename: Antonio
authors.initials: A
authors.lastname: Romeo
authors.forename: Luca
authors.initials: L
authors.lastname: Macarini
authors.forename: Eugenio Annibale
authors.initials: EA
authors.lastname: Genovese
authors.forename: Luca
authors.initials: L
authors.lastname: Brunese
references.citation: J Clin Invest. 2005 Oct;115(10):2598-608
references.pmid: 16200192
references.citation: Recenti Prog Med. 2012 Nov;103(11):477-82
references.pmid: 23096735
references.citation: Radiol Med. 2012 Feb;117(1):148-59
references.pmid: 21892716
references.citation: AJR Am J Roentgenol. 1991 Nov;157(5):975-80
references.pmid: 1927822
references.citation: Radiology. 2010 Nov;257(2):587-8; author reply 588
references.pmid: 20959552
references.citation: Semin Ultrasound CT MR. 2012 Aug;33(4):379-82
references.pmid: 22824127
references.citation: AJR Am J Roentgenol. 2001 Jun;176(6):1441-5
references.pmid: 11373210
references.citation: Radiology. 2009 Sep;252(3):929; author reply 930-1
references.pmid: 19717758
references.citation: AJR Am J Roentgenol. 1983 Jan;140(1):101-4
references.pmid: 6600295
references.citation: J Clin Ultrasound. 1999 Oct;27(8):433-9
references.pmid: 10477885
references.citation: Radiology. 1990 Oct;177(1):1-10
references.pmid: 2204956
references.citation: J Ultrasound Med. 2008 Aug;27(8):1187-94
references.pmid: 18645077
references.citation: Infez Med. 2012;20 Suppl 1:14-9
references.pmid: 22982693
references.citation: AJR Am J Roentgenol. 2003 Jan;180(1):215-22
references.pmid: 12490508
references.citation: Radiol Med. 2005 Sep;110(3):249-61
references.pmid: 16200047
references.citation: AJR Am J Roentgenol. 1998 Oct;171(4):1055-60
references.pmid: 9762996
references.citation: Am J Obstet Gynecol. 2013 Mar;208(3):237.e1-2
references.pmid: 23220268
references.citation: Recenti Prog Med. 2012 Nov;103(11):471-6
references.pmid: 23096734
references.citation: Radiology. 1988 Apr;167(1):239-44
references.pmid: 3279456
references.citation: Radiology. 1990 Feb;174(2):297-307
references.pmid: 2404309
references.citation: Radiographics. 2004 Mar-Apr;24(2):497-506
references.pmid: 15026596
references.citation: Eur J Radiol. 2008 May;66(2):246-52
references.pmid: 17629431
references.citation: Eur J Endocrinol. 2008 Oct;159(4):447-51
references.pmid: 18644823
references.citation: J Urol. 1999 Aug;162(2):632
references.pmid: 10411099
references.citation: Radiology. 2005 May;235(2):530-6
references.pmid: 15758192