Kanno Toru, Kubota Masashi, Sakamoto Hiromasa, Nishiyama Ryuichi, Okada Takashi, Higashi Yoshihito, Yamada Hitoshi
Department of Urology, Ijinkai Takeda General Hospital, Kyoto, Japan.
Department of Urology, Ijinkai Takeda General Hospital, Kyoto, Japan.
Urology. 2014 Sep;84(3):533-7. doi: 10.1016/j.urology.2014.04.047.
To assess the efficacy of ultrasonography (US) for the detection of ureteral stone using non-contrast-enhanced computed tomography (NCCT) as a standard reference.
From January 2009 to September 2011, 428 patients underwent both NCCT and US on the same day. The sensitivity and specificity of US to detect ureteral stone was evaluated. The detection rates using US imaging were examined according to location and stone size. The sizes of stones determined in the longest axis of NCCT and US were compared. We also performed group classification based on size to examine whether stone sizes measured by NCCT and US were similar. Moreover, the factors that may affect the detection of ureteral stone by US were analyzed.
Out of 856 ureters, NCCT could detect 171 stones in 169 patients, whereas US could detect 98 stones, yielding a sensitivity of 57.3% and a specificity of 97.5%. Expectedly, detection rate of US increased with stone size but was lower for distal ureter. With hydronephrosis, the sensitivity of US improved from 57.3% to 81.3%. Stone sizes measured by US correlated positively with those by computed tomography, and were concordant with those of NCCT in 68 of 98 patients (69.4%). Interestingly, stone size and the presence of hydronephrosis were factors that independently affected ureteral stone detection by US.
These results indicate that US may be useful as an initial imaging modality for detecting ureteral stone.
以非增强计算机断层扫描（NCCT）作为标准参考，评估超声检查（US）检测输尿管结石的效能。
2009年1月至2011年9月，428例患者于同日接受了NCCT和US检查。评估了US检测输尿管结石的敏感性和特异性。根据结石位置和大小检查US成像的检出率。比较了在NCCT和US上沿最长轴测定的结石大小。我们还根据大小进行了分组分类，以检查NCCT和US测量的结石大小是否相似。此外，分析了可能影响US检测输尿管结石的因素。
在856条输尿管中，NCCT在169例患者中检测到171颗结石，而US检测到98颗结石，敏感性为57.3%，特异性为97.5%。不出所料，US的检出率随结石大小增加，但输尿管远端的检出率较低。伴有肾积水时，US的敏感性从57.3%提高到81.3%。US测量的结石大小与计算机断层扫描测量的结石大小呈正相关，98例患者中有68例（69.4%）与NCCT测量的结石大小一致。有趣的是，结石大小和肾积水的存在是独立影响US检测输尿管结石的因素。
这些结果表明，US可能作为检测输尿管结石的初始成像方式。
