Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul 15;5 Suppl 1(Suppl 1):S3.
doi: 10.1186/2036-7902-5-S1-S3. Epub 2013 Jul 15.

US detection of renal and ureteral calculi in patients with suspected renal colic

Gianfranco Vallone  1 , Giuseppina Napolitano, Paolo Fonio, Gabriele Antinolfi, Antonio Romeo, Luca Macarini, Eugenio Annibale Genovese, Luca Brunese
Affiliations

US detection of renal and ureteral calculi in patients with suspected renal colic

Gianfranco Vallone et al. Crit Ultrasound J. .

Abstract

Purpose: 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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Gray-scale sonogram shows hyperechoic spot with posterior acoustic shadowing. Color Doppler sonogram shows a twinkling sign. A small renal stone. Unenhanced CT confirms the presence of renal stone.
Figure 2
Figure 2
Unenhanced CT confirms the presence of renal stone. Grey-scale sonogram shows small hyperechoic spot without posterior acoustic shadowing. Color Doppler sonogram shows a twinkling sign.
Figure 3
Figure 3
Two small renal stones with calyceal dilatation. Grey-scale sonogram shows only one hyperechoic spot with posterior acoustic shadowing. Color Doppler sonogram reveals two twinkling signs.
See this image and copyright information in PMC

References

    1. Coe FL, Evan A, Worcester E. Kidney stone disease. J Clin Invest. 2005;5(10):2598–608. doi: 10.1172/JCI26662. [Full Text] - DOI - PMC - PubMed
    1. Middleton WD, Dodds WJ, Lawson TL. et al.Renal calculi: sensitivity for detection with US. Radiology. 1988;5(1):239–44. [Full Text] - PubMed
    1. Kane RA, Manco LG. Renal arterial calcification simulating nephrolithiasis on sonography. Am J Roentgenol. 1983;5:101–104. doi: 10.2214/ajr.140.1.101. [Full Text] - DOI - PubMed
    1. Taylor KJ, Holland S. Doppler US. Part I. Basic principles, instrumentation, and pitfalls. Radiology. 1990;5:297–307. [Full Text] - PubMed
    1. Lee JY, Kim SH, Cho JY. et al.Color and power Doppler twinkling artifacts from urinary stones: clinical observations and phantom studies. Am J Roentgenol. 2001;5:1441–1445. doi: 10.2214/ajr.176.6.1761441. [Full Text] - DOI - PubMed

LinkOut - more resources