Javid Mohamed, Ilangovan Ananda Kumar, Ganapathy Ramesh, Sivalingam Senthilkumar, Selvaraj Sudhakaran, Prasad Srikala, Elumalai Prabhu
Urology, Chengalpattu Medical College, Chengalpattu, IND.
Cureus. 2023 Nov 22;15(11):e49254. doi: 10.7759/cureus.49254. eCollection 2023 Nov.
Introduction Ultrasound (US) is frequently the initial diagnostic tool for urolithiasis, though computed tomography (CT) remains the imaging modality of choice. However, due to potential overestimations, the accuracy of US in gauging stone size has been a point of contention. This study aims to compare the accuracy of stone size measurements in US, specifically evaluating the utility of the posterior acoustic shadow (PAS) width, against the CT measurements. Methods We conducted a cross-sectional study where 120 adult patients (aged >18 years) with confirmed urolithiasis through CT participated. Stone sizes were assessed via both CT and US, with the PAS width also being measured in the latter. Statistical analysis compared stone size discrepancies between both CT and US measurement techniques. Results The study enrolled 73 males and 47 females with various stone locations. The average stone sizes were 15.93 ± 4.59 mm (CT), 18.60 ± 4.80 mm (US), and 16.69 ± 4.61 mm (PAS width). There was a mean difference of 2.67 mm (p < 0.0001) between CT and US sizes, whereas the difference between the PAS width and CT sizes was only 0.75 mm (p= 0.203). Stone size miscalculation by US was 16.77%, whereas it was only 4.77% for PAS width. Conclusion US tends to significantly overestimate stone size when compared to CT. Conversely, the measurement of the PAS width in US presents a more aligned estimation to CT outputs. Integrating PAS width into routine US reporting can enhance the accuracy of stone size estimation, optimizing urolithiasis management and patient counseling.
超声（US）常常是尿路结石的初始诊断工具，不过计算机断层扫描（CT）仍是首选的成像方式。然而，由于可能存在高估情况，超声在测量结石大小方面的准确性一直存在争议。本研究旨在比较超声测量结石大小的准确性，特别是评估后方声影（PAS）宽度的效用，并与CT测量结果进行对比。方法：我们开展了一项横断面研究，纳入了120名经CT确诊为尿路结石的成年患者（年龄>18岁）。通过CT和超声评估结石大小，超声还测量了PAS宽度。统计分析比较了CT和超声两种测量技术之间的结石大小差异。结果：该研究纳入了73名男性和47名女性，结石位于不同部位。结石平均大小分别为：CT测量值15.93±4.59毫米，超声测量值18.60±4.80毫米，PAS宽度测量值16.69±4.61毫米。CT和超声测量的结石大小平均差值为2.67毫米（p<0.0001），而PAS宽度与CT测量值之间的差值仅为0.75毫米（p = 0.203）。超声误判结石大小的比例为16.77%，而PAS宽度误判的比例仅为4.77%。结论：与CT相比，超声往往会显著高估结石大小。相反，超声测量PAS宽度的结果与CT测量结果更为接近。将PAS宽度纳入常规超声报告中，可以提高结石大小估计的准确性，优化尿路结石的管理和患者咨询。
