Department of Ultrasound, Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
Caixiang First Village Community Healthcare Service Center, Suzhou, 215004, China.
Urolithiasis. 2023 Apr 8;51(1):67. doi: 10.1007/s00240-023-01445-3.
To investigate the predictive value of hydronephrosis and hydroureter in the detection of ureteral stones using ultrasound, a total of 366 patients suffering from ureteral stones confirmed by ultrasound, computed tomography (CT) and their follow-up treatments were consecutively collected. All the included patients underwent systematic ultrasound scanning of the kidney and ureter. The hydronephrosis and hydroureter in each patient were measured using a digital caliper. Then, receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff values for hydronephrosis and hydroureter to predict a ureteral stone's location and size. The hydronephrosis, hydroureter, and stone size measurements showed good interobserver agreement (P < 0.001). Using the lower border of the sacroiliac joint as a demarcation point, we found larger widths of hydronephrosis and hydroureter in the proximal ureteral stone group than in the distal ureteral stone group (P < 0.001). Additionally, 10.9 mm and 5.9 mm were identified as optimal cutoff values for predicting a distal position (P < 0.001), with no significant difference in their predictive value (P > 0.05). Similar comparisons between groups based on size stratification revealed no significant difference in hydronephrosis between the > 5 mm group and the ≤ 5 mm group. However, the hydroureter was larger in the > 5 mm group than in the ≤ 5 mm group after identifying 6 mm as the best cutoff (P =0.004). In summary, the ultrasound measurement of hydronephrosis and hydroureter may predict the position and size of a possible ureteral stone in patients with colic symptoms.
为了研究超声检查中肾盂积水和输尿管扩张对输尿管结石的预测价值，我们连续收集了 366 例经超声、计算机断层扫描（CT）确诊并接受后续治疗的输尿管结石患者。所有纳入的患者均接受了肾脏和输尿管的系统超声扫描。使用数字卡尺测量每位患者的肾盂积水和输尿管扩张程度。然后，使用受试者工作特征（ROC）曲线分析确定肾盂积水和输尿管扩张的最佳截断值，以预测输尿管结石的位置和大小。肾盂积水、输尿管扩张和结石大小的测量结果具有良好的观察者间一致性（P<0.001）。以骶髂关节下缘为分界点，我们发现近端输尿管结石组的肾盂积水和输尿管扩张程度大于远端输尿管结石组（P<0.001）。此外，我们确定了 10.9mm 和 5.9mm 作为预测远端位置的最佳截断值（P<0.001），它们的预测价值无显著差异（P>0.05）。基于大小分层的组间比较显示，>5mm 组和≤5mm 组之间的肾盂积水无显著差异。然而，当确定 6mm 为最佳截断值时，>5mm 组的输尿管扩张程度大于≤5mm 组（P=0.004）。总之，超声检查肾盂积水和输尿管扩张程度可能有助于预测有绞痛症状的患者中可能出现的输尿管结石的位置和大小。
