Turrin Alberto, Minola Paolo, Costa Fortunato, Cerati Luciana, Andrulli Simeone, Trinchieri Alberto
Department of Radiology, Lecco Hospital, Lecco, Italy.
Urol Res. 2007 Dec;35(6):313-7. doi: 10.1007/s00240-007-0110-8. Epub 2007 Sep 15.
The aim of the study was to investigate the diagnostic value of the colour Doppler twinkling artefact (TA) in renal stone disease. To enhance the evidence of TA, a preliminary in vitro study was performed to optimise the setting of colour Doppler sonography. In the in vitro study, an oxen kidney was examined using an high-frequency (12.5 MHz) linear array probe in a water bath before and after the inoculation of an aliquot of powder obtained by fragmentation of a calcium oxalate stone. In the clinical study, 67 patients with diagnosis of urinary stone based on B-mode sonography and 67 matched control subjects were examined with colour Doppler sonography using a low-frequency (2.5 MHz) curvilinear phased array probe. In vitro, the injection of calcium oxalate powder in a bovine kidney sample induced the appearance of spots without any back shadowing appearance on B mode but with a large number of TA on colour Doppler. In vivo, TA was much more frequent in patients with stone disease (95.5%) compared to controls (9.0%) (P < 0.001). TA was highly associated to renal stone disease and was also present in renal areas where a stone was undetected with B mode approach suggesting its diagnostic role although further studies are needed to confirm its accuracy. The type of instrumentation and its setting is crucial to obtain reproducible results.
本研究的目的是探讨彩色多普勒闪烁伪像（TA）在肾结石疾病中的诊断价值。为了增强TA的证据，进行了一项初步的体外研究以优化彩色多普勒超声检查的设置。在体外研究中，在接种通过草酸钙结石破碎获得的一份粉末前后，使用高频（12.5MHz）线性阵列探头在水浴中检查牛肾。在临床研究中，对67例基于B型超声诊断为尿路结石的患者和67例匹配的对照受试者使用低频（2.5MHz）曲线相控阵探头进行彩色多普勒超声检查。在体外，向牛肾样本中注射草酸钙粉末会在B模式下产生无任何后方声影的斑点，但在彩色多普勒上会出现大量TA。在体内，与对照组（9.0%）相比，结石病患者中TA更为常见（95.5%）（P<0.001）。TA与肾结石疾病高度相关，并且在B模式检查未发现结石的肾区域也存在，这表明其具有诊断作用，尽管需要进一步研究来证实其准确性。仪器类型及其设置对于获得可重复的结果至关重要。
