Abstract:
OBJECTIVES:To evaluate differences in stone measurement using computed tomography (CT) and ultrasound (US). Axial unenhanced helical CT is the reference-standard imaging modality for the assessment of urinary tract calculi; however, US is also commonly used. Differences in stone measurement using these techniques are poorly described and contributors to measurement error remain unknown. METHODS:All patients at our institution undergoing both abdominal CT and renal US less than 1 month apart since June 2004 were reviewed. Solitary renal calculi were identified on both CT and US in all cases. RESULTS:We identified 71 calculi in 60 patients. Compared with CT, US overestimated stone size, an effect that was more pronounced with smaller calculi. The mean stone measurement on CT was 7.4 +/- 4.4 mm and on US it was 9.2 +/- 4.5 mm (P = .018). For stones =5 mm, US measurements were a mean of 1.9 +/- 1.2 mm greater than CT (P <.001). US and CT measurements were discordant for 60% of stones =5 mm. Discordance was associated with US measurement of skin-to-stone distance (P = .018), but not body mass index (P = .189) or location within the urinary tract (P = .161). Review of the literature revealed that US has a pooled sensitivity and specificity of 45% and 94%, respectively, for the detection of ureteric calculi and 45% and 88%, respectively, for renal calculi. CONCLUSIONS:US overestimates stone size in urolithiasis, a finding that may have implications for stone management. Discordance in stone measurement varies with size and is greatest in stones =5 mm. US measurement of skin-stone-distance is an important determinant of error in US measurement of renal calculi.
journal_name
Urologyjournal_title
Urologyauthors
Ray AA,Ghiculete D,Pace KT,Honey RJdoi
10.1016/j.urology.2009.12.015subject
Has Abstractpub_date
2010-08-01 00:00:00pages
295-300issue
2eissn
0090-4295issn
1527-9995pii
S0090-4295(09)03079-9journal_volume
76pub_type
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