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. 2024 Feb;17(2):226-232.
doi: 10.25122/jml-2023-0477.

Ultrasound accuracy in evaluating renal calculi in Maysan province

Saud Kadhim Abbas  1 , Thaer Saleh Sabor Al-Omary  1 , Hayder Adnan Fawzi  2
Affiliations

Ultrasound accuracy in evaluating renal calculi in Maysan province

Saud Kadhim Abbas et al. J Med Life. 2024 Feb.

Abstract

Renal calculi are a common clinical presentation. While ultrasound (US) is a widely used imaging modality for kidney stone diagnosis due to its accessibility and lower cost, its accuracy compared to computerized tomography (CT), the gold standard, remains understudied. This cross-sectional study evaluated the diagnostic accuracy of ultrasound for detecting and characterizing kidney stones compared to computed tomography (CT). Fifty-six patients with suspected kidney stones based on flank pain underwent abdominal ultrasound to assess stone presence, size, location, and the severity of any hydronephrosis (kidney swelling). These findings were then confirmed with a subsequent non-contrast CT scan. There was a fair agreement between US and CT (Kappa = 0.368) for detecting the stone location. The US could not detect 7 (12.5%) stones, being less sensitive in the middle and upper calyx compared to CT. There was a fair agreement between the US and CT (Kappa = 0.394) for detecting the severity of hydronephrosis. The US was less sensitive to moderate and severe hydronephrosis compared to CT. The abdominal ultrasound demonstrated excellent reliability for stone size measurement (intraclass correlation = 0.924), with CT measurements only slightly larger on average (mean difference 0.9 mm). Although abdominal ultrasound provides reliable stone size assessment, its capacity to accurately localize stones and assess hydronephrosis severity is limited.

Keywords: CI, Confidence Interval; CT, Computed Tomography; ICC, Intraclass Correlation; IVU, Intravenous Urography; KUB, Kidney-Ureter-Bladder X-ray; US, Ultrasound; hydronephrosis; nephrolithiasis; reliability; stone location; stone size.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study
Figure 2
Figure 2
Comparative analysis of stone size measurements using US and CT imaging. A, Truncated violin plot; B, Bland – Altman analysis; C, Correlation plot of stone size by radiological modalities
Figure 3
Figure 3
CT scan images of renal stone
Figure 4
Figure 4
US image of renal stones
See this image and copyright information in PMC

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