The Efficacy of Ultrasonography for the Detection of Renal Stone

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

doi:10.1016/j.urology.2014.04.010

Cited by 60 publications

(60 citation statements)

References 7 publications

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“…[2][3][4][5][6] We detail a number of findings that suggest S-mode US is more accurate at sizing renal stones than both previously published series and in direct comparison to a clinical US system. Estimated stone size from S-mode using the stone or acoustic shadow was within 1 mm of the CT size (95% confidence interval) for stones <10 mm.…”

Section: Discussionmentioning

confidence: 88%

“…1 The sensitivity of US for diagnosing renal stones compared with CT varies widely, from 24% to 70%. [2][3][4][5][6] The accuracy of US for sizing stones compared with CT has also been shown to differ widely, particularly with size and depth. [2][3][4][5][6] Anecdotally, many urologists feel US reports a significantly larger size than CT.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][5][6] The accuracy of US for sizing stones compared with CT has also been shown to differ widely, particularly with size and depth. [2][3][4][5][6] Anecdotally, many urologists feel US reports a significantly larger size than CT. This has resulted in a general lack of trust in US by the urology community as a primary modality for imaging renal stones, as accurate detection and sizing are important for surgical treatment planning and monitoring stone burden.…”

Section: Introductionmentioning

confidence: 99%

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Stone-Mode Ultrasound for Determining Renal Stone Size

May

Haider

Dunmire

et al. 2016

Journal of Endourology

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Purpose: The purpose of this study was to measure the accuracy of stone-specific algorithms (S-mode) and the posterior acoustic shadow for determining kidney stone size with ultrasound (US) in vivo. Materials and Methods: Thirty-four subjects with 115 renal stones were prospectively recruited and scanned with S-mode on a research US system. S-mode is gray-scale US adjusted to enhanced stone contrast and resolution by minimizing compression and averaging, and increasing line density and frequency. Stone and shadow width were compared with a recent CT scan and, in 5 subjects with 18 stones, S-mode was compared with a clinical US system. Results: Overall, 84% of stones identified on CT were detected on S-mode and 66% of these shadowed. Seventy-three percent of the stone measurements and 85% of the shadow measurements were within 2 mm of the size on CT. A posterior acoustic shadow was present in 89% of stones over 5 mm versus 53% of stones under 5 mm. S-mode visualized 78% of stones, versus 61% for the clinical system. S-mode stone and shadow measurements differed from CT by 1.6 -1.0 mm and 0.8 -0.6 mm, respectively, compared with 2.0 -1.5 mm and 1.6 -1.0 mm for the clinical system. Conclusions: S-mode offers improved visualization and sizing of renal stones. With S-mode, sizing of the stone itself and the posterior acoustic shadow were similarly accurate. Stones that do not shadow are most likely <5 mm and small enough to pass spontaneously.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stone-Mode Ultrasound for Determining Renal Stone Size

May

Haider

Dunmire

et al. 2016

Journal of Endourology

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“…Although we found a prevalence of stones similar to a previous study in a very selected population of kidney donors, 57 assessment by ultrasonography is associated with underdetection of stones compared with computed tomography. 57,58 The administration of vasopressin antagonist in order to reduce cystine stone formation was described in a case report. 59 To the best of our knowledge, there is no evidence for the association of AVP or copeptin with kidney stones.…”

Section: Discussionmentioning

confidence: 99%

Copeptin Is Associated with Kidney Length, Renal Function, and Prevalence of Simple Cysts in a Population-Based Study

Ponte

Pruijm

Ackermann

et al. 2015

Journal of the American Society of Nephrology

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Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P,0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (b=22.1; 95% confidence interval [95% CI], 23.3 to 20.8; P=0.002) and kidney length (b=21.2; 95% CI, 21.9 to 20.4; P=0.003) but positively with 24-hour urinary albumin excretion (b=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (b=0.08; 95% CI, 0.05 to 0.10; P,0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts. The antidiuretic hormone arginine vasopressin (AVP) plays an essential role in osmoregulation by facilitating water transport in the collecting duct. 1 This effect is mediated by the stimulation of the G protein-coupled vasopressin V2 receptor (V2R), increasing cAMP levels and leading to a transient increase in osmotic water transport across the principal cells. 2 Furthermore, it was recently demonstrated that V2Rs are also expressed in the thick ascending limb of the human kidney. 3,4 In addition to the V2R, AVP acts on the V1a receptor (Ca 2+ as second messenger), which is distributed in the endothelial cells lining systemic and renal blood vessels and capillaries (including vasa recta), as well as the glomerulus, the macula densa, the medullary interstitial cells, and the cortical collecting duct. [5][6][7] Of note, V1a receptors seem to

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“…Kanno et al reported a sensitivity of 100% for CT and only 70% for ultrasound for the detection of renal stones. 6 There was also a 21.1% chance of missing a stone altogether on ultrasound, and these were stones in the kidney, which arguably are much easier to identify than ureteral stones. Why are we even having this debate?…”

Section: Conmentioning

confidence: 99%