The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis

A prospective preliminary study

Artur Salmaslıoğlu, Mesut Bulakçı, Barış Bakır, Ravza Yılmaz, Yunus Emre Akpınar, Tzevat Tefik, Öner Şanlı, Sevda Özel, Bülent Acunas

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)169-174
Number of pages6
JournalDiagnostic and Interventional Radiology
Volume24
Issue number3
DOIs
StatePublished - May 1 2018

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Urolithiasis
Calculi
Prospective Studies
Ultrasonography
Color
Urinary Calculi
Tomography
Artifacts
Doppler Color Ultrasonography
Urology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis : A prospective preliminary study. / Salmaslıoğlu, Artur; Bulakçı, Mesut; Bakır, Barış; Yılmaz, Ravza; Akpınar, Yunus Emre; Tefik, Tzevat; Şanlı, Öner; Özel, Sevda; Acunas, Bülent.

In: Diagnostic and Interventional Radiology, Vol. 24, No. 3, 01.05.2018, p. 169-174.

Research output: Contribution to journalArticle

Salmaslıoğlu, Artur ; Bulakçı, Mesut ; Bakır, Barış ; Yılmaz, Ravza ; Akpınar, Yunus Emre ; Tefik, Tzevat ; Şanlı, Öner ; Özel, Sevda ; Acunas, Bülent. / The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis : A prospective preliminary study. In: Diagnostic and Interventional Radiology. 2018 ; Vol. 24, No. 3. pp. 169-174.
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AU - Bulakçı, Mesut

AU - Bakır, Barış

AU - Yılmaz, Ravza

AU - Akpınar, Yunus Emre

AU - Tefik, Tzevat

AU - Şanlı, Öner

AU - Özel, Sevda

AU - Acunas, Bülent

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N2 - 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.

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