Determining the Efficacy of Ultrasonography for the Detection of Ureteral Stone

Kanno, Toru; Kubota, Masashi; Sakamoto, Hiromasa; Nishiyama, Ryuichi; Okada, Takashi; Higashi, Yoshihito; Yamada, Hitoshi

doi:10.1016/j.urology.2014.04.047

Cited by 30 publications

(20 citation statements)

References 12 publications

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“…Konsekutiv liegt die Sensitivität des Ultraschalls im Harnleiterverlauf bei 45-57% und die Spezifität bei 94-98% [8,35]. Größenabhängig zeigt sich bei erfahrenen Untersuchern und Konkrementen <5 mm eine Sensitivität von etwa 31% und bei >5 mm von 70% ( [19], . Abb.…”

Section: Sonographieunclassified

“…1) Als indirekter Steinnachweis gilt die obstruktionsbedingte Ektasie des Nierenbeckenkelchsystems (NBKS) oder ein fehlender Ostienjet in der farbkodierten Duplexsonographie (FKDS, [13]). Liegt eine Ektasie vor, so verbessert sich die Sensitivität für eine Urolithiasis von 57 auf 81% [19]. Zwar kann ein postobstruktives Farbartefakt (Twinkling-Effekt) die Lokalisationsdiagnostik verbessern, die Sensitivität hierfür ist mit 55% aber eher schwach [7,37].…”

Section: Sonographieunclassified

“…Zusammenfassend ist die Sonographie der CT bezüglich einer akkuraten Steindiagnostik unterlegen [15,19]. Blickt man indessen auf den abschließenden Erfolg der Steintherapie, dann scheinen trotz geringerer Sensitivität der alleinigen Sonographie im Vergleich zum alleinigen CT vergleichbare Ergebnisse herauszukommen [42].…”

Section: Sonographieunclassified

“…Zusätzlich unterliegen Steinpatienten einer hohen kumulativen Strahlenexposition durch wiederholte Untersuchungen [19]. Demzufolge ist eine konsequente Berücksichtigung des Strahlenschutzes mit Anwendung modernster Technologien gerade hier von besonderer Bedeutung.…”

Section: » Vor Interventionellerunclassified

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Bildgebende Diagnostik bei Harnsteinen

Thalgott

Kurtz

Gschwend

et al. 2015

Urologe

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Section: Sonographieunclassified

Section: » Vor Interventionellerunclassified

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Bildgebende Diagnostik bei Harnsteinen

Thalgott

Kurtz

Gschwend

et al. 2015

Urologe

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“…Multiple studies have demonstrated considerably decreased sensitivity and specificity of US compared with CT for detection of both renal and ureteral calculi, particularly for small ( < 5 mm) stones. [18][19][20][21][22][23] In addition, US has been shown to overestimate stone size, which may have implications for management as discussed further below. 21 A 2010 article, however, indicated that a negative renal US for urolithiasis in the emergency department predicts a very low likelihood (0.6%) for urologic intervention, implying that US may miss stones that pass without intervention.…”

Section: Introductionmentioning

confidence: 99%

Low-Dose Computed Tomography in the Evaluation of Urolithiasis

BhattKavita

MongaManoj

Remer

2015

Journal of Endourology

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A systematic review and meta‐analysis of clinical signs, symptoms, and imaging findings in patients with suspected renal colic

et al. 2022

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Study Objective The objective of this study was to conduct a systematic review and meta‐analysis of the diagnostic accuracy of the clinical signs, symptoms, laboratory investigations, and imaging modalities commonly used in patients with clinically suspected renal colic. Methods We conducted this systematic review and meta‐analysis according to an a priori, registered protocol (PROSPERO CRD42017055153). A literature search was performed using MEDLINE and EMBASE from inception to July 2, 2020. We assessed the risk of bias using Quality Assessment of Diagnostic Accuracy Studies–2, calculated likelihood ratios (LRs), and applied a random‐effects model for meta‐analysis. Results Among 7641 references screened, 76 were included in the systematic review and 53 were included in the meta‐analyis. The overall pooled prevalence for ureteral stones was 63% (95% confidence interval [CI], 58%–67%). No individual demographic feature, symptom, or sign when present had an LR+ ≥2.0 for identifying ureterolithiasis. A (Sex, Timing and Origin of pain, race, presence or absence of Nausea, and Erythrocytes) STONE score ≥10 increased (sensitivity 0.49, specificity 0.91, LR 5.3 [95% CI, 4.1–6.7]) and a STONE score <6 reduced the likelihood of ureteral stones (sensitivity 0.94, specificity 0.43, LR 0.15 [95% CI, 0.10–0.22]). Standard‐dose (sensitivity 0.96, specificity 0.94, LR+ 16 [95% CI, 11–23], LR− 0.05 [95% CI, 0.03–0.07]) and low‐dose computed tomography (CT) scanning (sensitivity 0.93, specificity 0.94, LR+ 17 [95% CI, 8.8–31], LR− 0.08 [95% CI, 0.03–0.19]) were the most useful imaging techniques for identifying patients with or without ureteral stones. Conclusions Individual signs, symptoms, or the presence of microscopic hematuria do not substantially impact the likelihood of ureteral stones in patients with clinically suspected renal colic. The STONE score at high and low thresholds and a modified STONE score at a high threshold may sufficiently guide physicians’ decisions to obtain imaging. Low‐dose, non‐contrast CT imaging provides superior diagnostic accuracy compared with all other imaging index tests that are comparable with standard CT imaging. Limitations of the evidence include methodological shortcomings and considerable heterogeneity of the included studies.

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Determining the Efficacy of Ultrasonography for the Detection of Ureteral Stone

Cited by 30 publications

References 12 publications

Bildgebende Diagnostik bei Harnsteinen

Bildgebende Diagnostik bei Harnsteinen

Low-Dose Computed Tomography in the Evaluation of Urolithiasis

A systematic review and meta‐analysis of clinical signs, symptoms, and imaging findings in patients with suspected renal colic

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