B-mode ultrasound versus color Doppler twinkling artifact in detecting kidney stones

Mathew D Sorensen, Jonathan D Harper, Ryan S Hsi, Anup R Shah, Manjiri K Dighe, Stephen J Carter, Mariam Moshiri, Marla Paun, Wei Lu, Michael R Bailey
Journal of Endourology 2013, 27 (2): 149-53

PURPOSE: To compare color Doppler twinkling artifact and B-mode ultrasonography in detecting kidney stones.

PATIENTS AND METHODS: Nine patients with recent CT scans prospectively underwent B-mode and twinkling artifact color Doppler ultrasonography on a commercial ultrasound machine. Video segments of the upper pole, interpolar area, and lower pole were created, randomized, and independently reviewed by three radiologists. Receiver operator characteristics were determined.

RESULTS: There were 32 stones in 18 kidneys with a mean stone size of 8.9±7.5 mm. B-mode ultrasonography had 71% sensitivity, 48% specificity, 52% positive predictive value, and 68% negative predictive value, while twinkling artifact Doppler ultrasonography had 56% sensitivity, 74% specificity, 62% positive predictive value, and 68% negative predictive value.

CONCLUSIONS: When used alone, B-mode is more sensitive, but twinkling artifact is more specific in detecting kidney stones. This information may help users employ twinkling and B-mode to identify stones and developers to improve signal processing to harness the fundamental acoustic differences to ultimately improve stone detection.

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