Diagnostic and Interventional Radiology
Modality-based (US, CT, MRI, PET-CT) Imaging - Original Article

The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study

1.

Department of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey

2.

Department of Urology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey

3.

Department of Biostatistics, İstanbul University İstanbul School of Medicine, İstanbul, Turkey

Diagn Interv Radiol 2018; 24: 169-174
DOI: 10.5152/dir.2018.18005
Read: 674 Downloads: 259 Published: 03 September 2019

Abstract

PURPOSE:We aimed to determine the feasibility and effectiveness of agent emission imaging - high mechanical index (AEI-High MI) mode ultrasonography (US) compared with gray-scale and color Doppler US, alone or in combination, for the diagnosis of urolithiasis with reference to unenhanced computed tomography (CT).

 

 

METHODS:This prospective study included 72 consecutive patients (40 males, 32 females; mean age, 45.9±14.7 years) referred by the department of urology for acute or elective symptoms of urolithiasis and confirmed to have urinary calculi on unenhanced abdominal CT, between January 2015 and June 2015. Gray-scale, color Doppler, and AEI-High MI US were performed by two radiologists to determine the effectiveness of these methods in the diagnosis of urinary stones and to compare them with the reference modality. 

 

 

RESULTS:A total of 189 calculi were detected on CT examination. Gray-scale US had a sensitivity of 66.1% and positive predictive value (PPV) of 88.7% for detecting calculi, while twinkling artifact of color Doppler had a sensitivity of 70.4% and PPV of 94.3%. The scintillation artifact of AEI-High MI mode had a sensitivity of 75.1% and PPV of 95.9%. When all ultrasound-based modalities were combined, the sensitivity and PPV rose to 83.1% and 88.2%, respectively. When calculi were grouped according to their size (<5 mm, 5–10 mm, >10 mm), AEI-High MI mode had a higher sensitivity (60%) compared with gray-scale (32.5%) and color Doppler (41.3%) for calculi <5 mm.

 

CONCLUSION:AEI-High MI mode had a higher sensitivity compared with gray-scale and color Doppler for the detection of calculi smaller than 5 mm, but it did not make a significant contribution to detection of larger calculi. The combined use of gray-scale US with AEI-High MI mode could increase the detection rate of calculi smaller than 5 mm and provide a method for verification of suspected calculi on gray-scale US.

 

You may cite this article as: Salmaslıoğlu A, Bulakçı M, Bakır B, et al. The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study. Diagn Interv Radiol 2018; 24:169–174.

 

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